Post-licensing visit·September 2, 2025

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility to conduct an unannounced Post-Licensing visit at 12:15PM. The LPA was greeted by staff, informed them of the reason for the visit, and staff notified the Licensee. The Licensee Kajo Movsesian arrived shortly thereafter. Entrance interview conducted. Beginning at 12:34PM, the LPA and the Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and the facility is in compliance with Title 22 Regulations. The following was observed: COMMON AREAS: At the time of the visit, the living room and dining room furniture was observed to be in good condition. The living room had a screened and inoperable fireplace. The facility maintained a comfortable temperature throughout the visit. LPA Huynh noted required postings in the facility’s entryway. Two (2) fire extinguishers were observed throughout the facility and were purchased within the last year. LPA observed nightlights throughout the facility’s hallways. Additionally, a laundry closet was in the hallway and was observed to be operable and in good condition. An additional closet was was the dining room that contained linens and clothes. Report Continued on LIC 809-C KITCHEN: Knives were stored inaccessible in a locked drawer. Cleaning supplies were inaccessible under the sink. Kitchen appliances were clean and in operable condition. The facility had a sufficient supply of perishable and non-perishable food, as well as emergency food and water. Food in the refrigerator was observed to be of good quality. Files, medications, and the first aid kit were stored in a locked cabinet. BEDROOMS/RESTROOMS: There were four (4) total bedrooms: two (2) private and two (2) shared. Bedrooms #1, #3, and #4 had direct exits to the outside and were approved for bedridden residents. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There were two (2) total restrooms in the facility, both shared in the hallways. Restrooms were clean and sanitary and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap and paper products. Hot water was tested and measured between 118.2 degrees F and 118.9 degrees F. OUTDOOR AREA: The backyard had an area equipped with furniture for resident and visitor use. There was one (1) self-latching side gate for emergency use. No bodies of water noted, and exits were free of obstructions. The facility had two (2) outdoor sheds that contained cleaning equipment and facility supplies. In the rear, there was an Additional Dwelling Unit (ADU) that was inaccessible to residents and occupied by unrelated individuals. RECORDS: Record review began at 12:56PM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. Report Continued on LIC 9099-C INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and reviewed annually as required. Emergency disaster drills are conducted quarterly, with the last documented drill on 07/15/2025. Combination smoke and carbon monoxide alarms were tested at 12:54PM and were operational. MEDICATIONS: Medication review began at 2:29PM. Medications were centrally stored and kept inaccessible in the kitchen. Medications were observed for two (2) residents. Medications were labeled and checked for expiration dates. Medications were properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. No deficiency cited. Exit interview conducted. A copy of today's report was reviewed and provided.