Pre-licensing visit·September 11, 2025

Licensing Program Analyst (LPA) Sandra Urena conducted a Pre-licensing visit and met with the applicant Satenik Alajanyan. This is a new facility application for a Residential Facility for the Elderly (RCFE) for four (4) ambulatory residents. Fire Clearance was approved on 06/27/2025. At 10:05 a.m., the LPA, and the applicant toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility will be following Title 22 Regulations. COMMON AREAS: The living room area is equipped with a television; there is a dedicated area for the posting of required documents at the entrance of the facility; some postings were missing, see ADMINISTRATION section below. Smoke and carbon monoxide alarms were tested and functional at the time of the visit. Medications will be stored in a locked top kitchen cabinet. The residents’ and staff files will be stored and locked in a file cabinet by the living room area. The living room furniture will be re-arranged for better use of the dining room table. Currently sofas are too close to the dining room table, reducing the practical space of the dining table and the dining room chairs. LAUNDRY: There is a laundry area, however, it is not equipped with a washer and dryer. Once washer and dryer are installed, the folding doors will also be adapted with a lock. The Detergents and cleaning supplies will be stored in a locked cabinet under the sink. Continues on LIC 809C...pg2. KITCHEN: Kitchen knives are stored locked and inaccessible in a locked kitchen drawer. A seven-day (7) supply of non-perishable food was available. The applicant will put the 7-day supply of canned goods and water together in one area, as they are currently found in two different areas within the kitchen cabinets. The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. The applicant will purchase two thermometers for the refrigerator; one for the refrigerator bottom and one for the top (freezer) to ensure the food is kept at a safe temperature. Kitchen cleaning supplies will be stored and locked under the kitchen sink. Hot water temperature was recorded at 118.9 degrees Fahrenheit. One trashcan with a tight-fitting lid needs to be purchased for the kitchen. There were no pesticides or toxins stored near food, or preparation area. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. A fire extinguisher is located near the hallway leading to the bedrooms, it had a handwritten tag with date of purchase of 04/01/2025. The Applicant will provide proof of purchase and attach receipt to the fire extinguisher. BEDROOMS: All bedrooms were cleared for ambulatory residents only. There are two (2) bedrooms for residents in care. Bedrooms # 2 and #1 will be used as shared rooms. Bedroom #2 lacks the following items and requires the following adaptations: Lacks two (2) chairs, one(1) night stand, one (1)lamp. The closet’s clothes bar on both sides needs to be lowered to be within the residents’ reach. The low closet’s bar on the left side needs to be removed. Add baskets in the closet divider. Bedroom # 1 lacks the following items, and requires the following adaptations: Lacks two (2) chairs, one(1) night stand, one (1)lamp, add partition to closet to separate clothes, clothes bar needs to be lowered to be within the residents’ reach, remove lower bar. SUPPLIES: All bedrooms require additional linens (sheets, pillowcases, blankets, bedspreads). Nightlight is present in the hallway. BATHROOMS: There are two (2) full bathrooms, with a shower area. Bathrooms are equipped with toilets and shower grab bars, and non-skid mats. There are sufficient supplies of towels, paper goods and personal hygiene supplies. The hot water was recorded at 118.9 degrees Fahrenheit. Both bathrooms need tight fitting lid trashcans. ADMINISTRATION: The following postings were missing- Facility Theft and Loss, Licensing Complaint Poster, and the Resident Council Rights. Continues on LIC 809C...pg3. ACTIVITIES: There were no activities supplies, reading materials (daily newspaper, current magazines, or variety of reading materials) or equipment were available at the time of the visit. SURROUNDING GROUNDS/OUTDOOR AREA: The exterior passageways were clean. The patio is furnished with outdoor furniture for residents’ use; however, the patio shade was missing. The building has a central entrance for residents and visitors. The right passageway is cleared and has a self-latching gate. The self-latching mechanism is located inside the gate. The applicant will remove the following items from the outdoor area: Wheelchair, dolly, glass, walker. Pre-Licensing is incomplete with deficiencies to be resolved by 09/22/2025. Follow up Pre-licensure LIC809 will be generated upon resolution. There is a laundry area, however, it is not equipped with a washer and dryer. The applicant will purchase two thermometers for the refrigerator; one for the refrigerator bottom and one for the top (freezer) to ensure the food is kept at a safe temperature. One trashcan with a tight-fitting lid needs to be purchased for the kitchen. The Applicant will provide proof of purchase and attach receipt to the fire extinguisher. Bedroom #1 lacks the following items and requires the following adaptations: Lacks two (2) chairs, one(1) night stand, one (1)lamp. The closet’s clothes bar on both sides needs to be lowered to be within the residents’ reach. The low closet’s bar on the left side needs to be removed. Add baskets in the closet divider. Bedroom # 2 lacks the following items, and requires the following adaptations: Lacks two (2) chairs, one(1) night stand, one (1)lamp, add partition to closet to separate clothes, clothes bar needs to be lowered to be within the residents’ reach, remove lower bar. All bedrooms require additional linens (sheets, pillowcases, blankets, bedspreads). Bathrooms need tight fitting lid trash cans. The following postings were missing- Facility Theft and Loss, Licensing Complaint Poster, and Resident Council Rights. Remove the following items from the outdoor area: Wheelchair, dolly, glass, walker. Add patio shade to patio sitting area. The applicant completed Component III orientation. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview was conducted and reviewed with the applicant. A copy of the report was issued.