Pre-licensing visit·August 20, 2025

Licensing Program Analyst (LPA) Quoc Huynh conducted an announced pre-licensing visit to the above noted facility. At 9:37AM, the LPA met with applicants, Mary Petikyan and Manvel Minasyan. Entrance interview conducted. An application to operate a Residential Facility for the Elderly was submitted on 02/25/2025. A dementia program was included in the plan of operation. A Hospice Waiver for 4 (four) has been requested. The facility's fire clearance was approved on 07/01/2025 for one (1) bedridden and five (5) non-ambulatory, with a total capacity of six (6) residents. Component II orientation was completed on 07/31/2025. Component III was completed with the applicants during today's visit. The facility is a single-story home located in Sherman Oaks. Beginning at 9:41AM, a physical plant tour was conducted. The following was observed: KITCHEN: Knives were stored in a locked kitchen drawer. The supply of dishes, utensils, pots, pans and drinkware was adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of nonperishable foods and emergency food supply was adequate. Cleaning supplies were stored in a locked cabinet under the kitchen sink. There were no pesticides or toxins stored in any food storage area or preparation area. Appliances in the kitchen were clean and all appeared functional. Medication s and files will be stored in a locked file cabinet located in the staff room. Report Continued on LIC 809-C BEDROOMS/BATHROOMS: The facility had seven (7) bedrooms: six (6) private resident rooms and one (1) staff room. Bedrooms #3, #6, and the staff room have direct exits to the outside with Bedroom #6 approved for one (1) bedridden resident. Bedroom #1 had a screened and inoperable fireplace. Resident rooms were set up with beds, nightstands, lamps, chairs, sufficient clothing storage and closet space. The beds were furnished with box springs, comfortable mattress and clean linen, which includes, a mattress pad, top and bottom linens, pillowcases, and blanket (if needed). Lighting in the rooms appeared adequate. The bedrooms were large enough to allow for easy passage between the beds and furniture with a wheelchair or walker. In addition, no bedroom was used as a passageway to another room, bath or toilet. All rooms were free of odors. All window screens were clean and maintained in good repair. There were five (5) bathrooms: three (3) private resident bathrooms and two (2) shared common bathrooms. The bathrooms had a shower with non-slip mats. One (1) hallway bathroom contained a laundry closet that was secured, and machines were in good condition. The toilet and shower had grab bars. The hot water temperature was tested and measured within the required range of 105*F to 120*F. COMMON AREAS: Common areas were appropriately furnished, and the lighting was adequate. There was a television, reading materials, and/or activity supplies in the living room. There was sufficient space to accommodate both indoor and outdoor activities. All ramps were secured and non-slippery and were positioned at the level where wheelchairs and walkers may enter and exit the facility safely. Alarms on all exterior doors were engaged at the time of visit and functional. In addition, the physical plant is consistent with the submitted facility sketch/floor plan. The facility had emergency lighting, which included but not limited to flashlights. Nightlights were observed throughout the common areas. The facility had emergency food and water available. The facility has central heating and air conditioning to maintain rooms to a comfortable temperature. Report Continued on LIC 809-C At 10:05AM, the hardwired combination smoke and carbon monoxide detectors as well as fire doors were tested and functioned properly. The fire extinguishers throughout the facility were fully charged and purchased on 04/24/2025. The supply of extra bed and bath linens as well as personal hygiene items were adequate in the hallway closet. Extra incontinence supplies and other supplies were located outside in the locked garage storage. There was a functioning telephone on the premises. All required postings were posted near the entrance of the facility. First aid kit was observed to be complete, including a thermometer and a current version of a first aid manual. OUTDOOR AREA: The exterior passageways were clean and clear of any obstructions. There were two (2) areas at the back of the house with tables and chairs where residents can sit. The outdoor space is property gated. There were no bodies of water on the premises at the present time. There was one (1) emergency exit that led to the front yard which contained a remote operated driveway gate and a self-latching door gate for everyday usage. The premises had a locked garage that was used as facility storage and also contained extra food with a refrigerator. No corrections required. Exit interview conducted. A copy of the report was reviewed and provided. 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 the approval of your license.