Pre-licensing visit·April 8, 2025

Licensing Program Analyst (LPA) Sandra Urena conducted a Pre-licensing visit and met with the Licensee Edgar Zatikian and Administrator Ani Navruzyan. This is a new facility application for a Residential Facility for the Elderly (RCFE) for six (6) non-ambulatory residents; one (1) of which may be a bedridden resident(s). Waiver was granted for hospice care for six (6) residents. Fire Clearance was approved on 03/14/2025. Bedridden resident approved in bedroom #4. 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, and the fireplace is non-functional and is currently covered with a movable screen. The licensee stated that they will secure the screen to prevent it from being moved. There is a dedicated area for the posting of required documents at the entrance of the facility, and the living room area. Smoke and carbon monoxide alarms were tested and functional at the time of the visit. Medications will be stored in a locked cabinet in the office area located in the corner of the living room area. The residents’ and staff files will be stored and locked cabinets located in the office area. LAUNDRY: There is a laundry area equipped with washer and dryer. The washer and dryer are located in a room next to the kitchen. Detergents and cleaning supplies will be stored in a locked cabinet under the kitchen sink. Continues on LIC 809 C... KITCHEN: Kitchen knives are stored locked and inaccessible in a locked kitchen drawer. A seven-day supply of non-perishable food was available. The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen cleaning supplies will be stored and locked under the kitchen sink. Hot water temperature was recorded at 115.6 degrees Fahrenheit. Trash cans have a tight-fitting lid. There were no pesticides or toxins stored near food, or preparation area. The first aid supplies were complete, including current version of a first aid manual. A fire extinguisher is located near the kitchen, which was purchased on 08/14/2024. BEDROOMS: There are four (4) bedrooms for residents in care. Rooms # 2 and 3 will be used as private rooms. Room #4 is approved for one (1) bedridden resident. Rooms # 1 and 4 will be shared rooms; all bedrooms are cleared for non-ambulatory. All bedrooms were supplied with all required bedding and linens. There is sufficient lighting as well as closet and drawer space available. Bedrooms #2 and #3 will need walls painted. Bedroom #1, air vent needs to have dust removed, and ceiling cleared of web. Remove wheelchair from bedroom #2. BATHROOMS: There are three (3) full bathrooms with shower area. One bathroom is a private bathroom located in bedroom #4. Bathroom #1 by the entrance needs to have grab bars added to the toilet, handwashing sign posted, and shower curtain added. Bathroom #2 needs bottom of shower step over area to be sharp. Remove towel rack to make it easier to reach toilet lever. Private bathroom, add handwashing sign. 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. Hot water delivered was between 115.6 to 119.8 degrees Fahrenheit. Continues on LIC 809C... SURROUNDING GROUNDS/OUTDOOR AREA: The patio is furnished with outdoor furniture for residents’ use, and shade is available. The building has a central entrance for residents and visitors. Left passageway is cleared. Right side area needs to be cleared of debris. Licensee and Administrator were advised that the main sliding gate needs to remain unlocked. Pre-Licensing is incomplete with deficiencies to be resolved by April 14, 2025. Follow up Pre-licensure LIC809 will be generated upon resolution. · Bedrooms #2 and #3 will need walls painted. Bedroom #1, air vent needs to have dust removed, and ceiling cleared of web. Remove wheelchair from bedroom #2. · Bathroom #1 by the entrance needs to have grab bars added to the toilet, handwashing sign posted, and shower curtain added. Bathroom #2 needs bottom of shower step over area to be sharp. Remove towel rack to make it easier to reach toilet lever. · Right side area needs to be cleared of debris. 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.