Pre-licensing visit·May 30, 2025

Licensing Program Analyst (LPA) Christine Yee conducted an announced Prelicensing and Component III visit to ensure that the home is in compliance with Title 22. The CARE Inspection Tool was utilized. LPA Yee met with Claudia Heshmati, Designated Applicant and Kevin Kalantar Ohanian, Corporate Officer. The facility is a single storey family home consisting of a living room, a dining room, a kitchen, 4 resident bedrooms and 2 full bathrooms. The facility is fire cleared for 5 NON-AMBULATORY and 1 BEDRIDDEN residents. Bedroom #4 is the bedroom designated for bedridden use. The following was observed on today's visit: The following were observed on today's visit: The living room and dining room are furnished with the appropriate furnishing and seating for 6 residents. The kitchen has a stove, dishwasher and refrigerator. Sufficient plates, cups, utensils for 6 residents were observed. Pots, pans, storage containers were observed. Perishable foods for a minimum of 2 days will be purchased prior to accepting the first resident and sufficient non-perishable for a minimum of 7 days was observed maintained on the premises. Located in the kitchen is the only fire extinguisher that was purchased on 7/2/24. Employment Poster was posted in the dining room and the required posting were observed in the living room. Page 2 Bedroom #1, directly by the front door, was observed with 2 hospital bed, 2 night stands, 2 lamps, 2 folding chairs, 2 dressers, television and 2 closets. The required bed linens were observed on the beds. Bedroom #2 is a private room and contains 1 bed, 1 folding chair, 1 night stand, 1 lamp, a television and a dresser. Also located in the room is the resident's personal massage chair Bedroom #3 is a shared room and was observed with 2 beds, 2 chairs, 2 night stands, 2 lamps, 2 dressers, a television and a shared closet. Located inside the room is a private bathroom equipped with a tub with shower, a toilet and 2 sink vanity. Grab bars were observed in the shower and behind the toilet. Slip resistant map was observed. Water temperature was tested and read 112.8 degrees Fahrenheit. Bedroom #4 is a private room with a hospital bed with half bed rails, a night stand, a lamp, a chair, dresser, television and a closet. A door in the room leads directly to a ramp located outside. The window blind on the right window was broken. The common bathroom is equipped with a shower stall, a bath tub, a toilet, and a single sink. Grab bars were observed in the shower and behind a toilet. A grab needs to be installed for the bath tub. The water temperature was tested and read 113.4 degrees Fahrenheit. The laundry room was observed with a washer and dryer. Cleaning solutions, laundry detergent, hygiene products were stored on a shelf in the room. Per the Applicant, the room is always locked. The auditory device on the outside exiting doors - front door, kitchen door and bedroom #4 were tested and were operational. The backyard has a covered patio furnished with a coffee table, a rattan love seat, 2 arm chairs and a bench for activities. The creeping plant along the back wall needs to be trimmed and the weeds need to be removed from the back yard. The front yard was clean. 2 rattan chairs and a coffee table were observed in the front patio. Trash cans in the front yard were observed to be tightly sealed. A first aid kit and first aid manual was observed. The only carbon monoxide located above the door of bedroom #4 was tested and was operational. The hard wired smoke alarms located in the 3 resident rooms and the hallway was tested and Page 3 was operational. The facility has a land line phone. The telephone # is (818)387-8161. The following corrections need to be completed prior to licensure: the right side blinds in bedroom #4 needs to be replaced. the vines on the back wall needs to be trimmed and the weeds removed. a grab bar and a slip resistant mat needs to be placed for the bath tub. the LIC610 - Emergency and Disaster Plan needs to be completed to include all emergency telephone numbers. The facility will update their Admission Agreement to include their policy on the prohibition or the retention of firearms. The Emergency Disaster Preparedness Plan needs to be revised to include additional information on the planned sheltering in place procedures, being self reliant for a period of 72 hours, transportation needs, communication needs, provisions for emergency power, operating of assistive medical devices, assisting residents with self administration of medications. The following needs to be completed upon licensure: create new resident, staff and volunteer files under the new license and name purchase liability insurance with limits of a $1 million per occurrence and a total annual aggregate of $3 million. Component III was conducted with Claudia Heshmati, Applicant and Kevin K Ohanian, Corporate Officer. Applicant will notify LPA Yee once the corrections have been completed Exit interview was conducted and a copy of this report was provided.