Routine inspection·December 8, 2025

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection. Upon arrival at the location, LPA Yee made contact with the home via the telephone number provided in the facility profile and was informed by Andranik Khachatrian, Corporate Officer that the facility doses not have any residents. LPA Yee explained that an annual inspection is still needed. Kachik Rumelyan, Administrator, was contacted and he arrived at 10:32am to conduct the visit. The reason for today's visit was provided. The home is a single storey family home consisting of a living room, dining room, kitchen, 4 bedrooms, 3 full bathrooms and a attached garage. Located in the back is a ADU with an address of 6702 Ben Avenue and is not part of the facility operations. The facility is fire cleared for 5 non-ambulatory residents and 1 bedridden resident. Bedroom #1 is fire cleared for bedridden use. The home is approved for 6 hospice waivers. On today's visit, LPA Yee conducted a tour or the facility inside and outside to observe the physical plant. The CARE Inspection Tool was not used to conduct the annual inspection today since the facility does not have any residents or staff and there are no files to review. Per tour of the facility, the following were observed: all the required furniture, fixtures and linens were observed in the living room, dining room, kitchen and bedrooms as it was during the Prelicensing visit. The fire place in the living room is capped off and made inaccessible by a fire screen. Bed linens were on the beds and extras observed in the linen closet. continued on LIC809-C Page 2. all three common bathrooms are equipped with grab bars and slip resistant mats. Water temperature was not tested since the water heater was turned off due to not having any residents. The Licensee was reminded to check the water temperature prior to accepting the first resident. no perishable foods for a minimum of 2 days was observed. Non-perishable foods were observed but is not sufficient for a minimum of 7 days and needs to be supplemented and must be maintained on the premises once residents are placed in the home. Currently there are no residents. The Licensee was reminded that the required foods be purchased prior to accepting the first resident. The hardwired smoke detectors located in the resident bedrooms, dining room, living room and the combination smoke/carbon monoxide detectors located in the hallways were tested and were operational. Auditory devices located on the front door, the door in bedroom #1 and the backdoor were tested and were operational. Medications will be locked in a kitchen cupboard. First aid kit was observed with a tweezer, scissors and thermometer. First aid manual was observed. Cleaning solutions are stored in a locked cabinet in the common bathroom located by bedroom #3. The facility has current general liability insurance that meets Title 22 requirements The laundry room located towards the left side of the home was observed with a washer and dryer. The attached garage is used primarily for storage. The backyard was observed with seating and a table. The tent covering is in the process of being replaced due damage caused by the winds. The trash cans are in the process of being replaced by the city. Per the administrator, multiple requests were made and the city has not delivered new trash cans. Per tour of the inside and outside of the home, the areas were observed to be clean. The Licensee will create staff and resident files once the licensee accepts residents and hires staff No deficiencies were cited on today's visit. Exit interview was conducted and copy of this report was provided.