Pre-licensing visit·November 18, 2025

Licensing Program Analyst (LPA) Quoc Huynh conducted a Pre-Licensing visit to the above noted facility. At 9:59AM, the LPA met with Applicant Mariam Panikyan. An application to operate a Residential Facility for the Elderly was submitted on 7/21/2025. A dementia program was included in the plan of operation. A Hospice Waiver for 6 (six) has been requested. The facility's fire clearance was approved on 9/26/2025 for six (6) non-ambulatory, with a total capacity of six (6) residents. Component II orientation was completed on 10/15/2025. Component III was completed with the Applicant during today's visit. The facility is a single-story home located in Van Nuys. Beginning at 10:03AM, 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 is adequate. The freezer was maintained at 0*F and the refrigerator was maintained at 40*F. The supply of nonperishable foods and emergency food supply is adequate. Cleaning supplies were stored in locked cabinets. 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 will be stored in a locked kitchen cabinet. Files will be stored in a locked file cabinet in the office area. First aid kit was observed to be complete, including a thermometer and a current version of a first aid manual. Report Continued on LIC 809-C 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 a fireplace that was properly screened. There was sufficient space to accommodate both indoor and outdoor activities. All ramps were secure 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. At 10:29AM, the hardwired combination smoke and carbon monoxide detectors as well as fire door were tested and functioned properly. Fire extinguisher was fully charged and purchased on 6/16/2025. The supply of extra bed and bath linens as well as personal hygiene items were adequate. Extra incontinence supplies and other supplies were located in each restroom. There was a washer and dryer located in the locked garage and observed to be in good condition. There is a functioning telephone on the premises. All required postings were posted near the garage entrance. BEDROOMS/BATHROOMS: The facility had four (4) bedrooms. 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. All rooms were free of odors. All window screens were clean and maintained in good repair. There were three (3) bathrooms: one (1) private, one (1) jack and jill, and one (1) half bath in the hallway. The bathrooms have a shower with non-slip mats. The toilet and shower have grab bars. The hot water temperature was tested and measured within the required range of 105*F to 120*F. Report Continued on LIC 809-C During today’s visit the LPA observed Bedroom #2 did not have access to a full restroom with a shower without using another Bedroom as a passageway. The Applicant proposed utilizing Bedroom #2 as an office with the remainder of the Bedrooms utilized as dual occupancy. The LPA will communicate with the Fire Inspector and verify the change. The Applicant will submit an updated floor plan upon clearance. OUTDOOR AREA: The exterior passageways were clean and clear of any obstructions. There was furniture in the rear with tables and chairs where residents can sit. The outdoor space is property gated. There are no bodies of water on the premises at the present time. One (1) side gate with a self-latching mechanism was observed. The LPA also observed an Additional Dwelling Unit (ADU) that was separated and unrelated to the facility. 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. No corrections required. Exit interview conducted. A copy of the report was reviewed and issued.