Follow-up·May 22, 2025

LIcensing Program Analyst (LPA)s Mary Flores and Blanca Gonzalez conducted an unannounced case management visit to follow up on capacity increase request submitted to the department on 8/21/24. LPAs met with Zara Poghosyan and explained the reason for the visit. The facility is currently licensed to serve 99 non-ambulatory residents over the age of 60, of which 14 may be non-ambulatory in rooms #101,102,103,104,105,106,107,122 (rooms #101 and 122 are allowed only 1 non-ambulatory resident). The facility is located in a residential area and consist of a two level building with two dining rooms, a lobby area, a commercial kitchen, a courtyard, an activity room, several rooms, front patios, and a garage area in the back. No changes have been done to the building. The capacity increase will take place by changing current bedrooms into shared resident bedrooms. The Fire Clearance was granted on 4/17/25 for 92 ambulatory residents and 14 non-ambulatory residents over the age of 60. The facility does not serve dementia residents and does not have a memory care unit. LPA toured the facility with Zara Poghosyan and observed common areas, kitchen, and the following resident rooms: #103,105, 111,115,119, 204, 210, 215,218 which were randomly chosen. Room #218 was observed currently being used as storage for linens. Rooms #204, 210, 215,218 have lighting. However, bulbs were very dim and do not light up the entire room. Additional lighting is required. Shower curtain in room #210 was observed ripped. Room #215 was missing side grab bar near the shower. Resident #1(R1)'s bed was observed with half bed rails on one side of the bed and a large box per the residents initiative to obtain privacy in room #119. Dining room floor by the entrance has a rise of about a 2ft by 3ft with a height of about 4 inches from ground level. Facility has a camera system to allow entry to the facility to residents and staff by facial recognition. (CONTINUED ON LIC 809C) Guest and visitors may call the receptionist to gain entry into the facility using the same system. Residents have signed a surveillance acknowledgment and may refused to participate. The main door does not open from the outside but opens from inside to allow exit of the facility. Passageways exit doors have a code which the staff are trained and have access to exit in case of an emergency. Codes and facial recognition have been place due to security reasons. Administrator will make the following corrections and will submit pictures to the department within 10 days: Will remove the items and ensure room #218 is ready for residents to move in. Will provide sufficient lighting to rooms #204,210,215,218. Will provide shower curtain in room #210. Will provide additional grab bar in room #215's shower. Will provide proper privacy means for resident R1 in share bedroom #119. Will fix the dining room floor. Will submit a sketch of the facility which notes non-ambulatory rooms. LPA was provided an updated LIC 200 during this visit. LPA will return at a different time to follow up on the items above. Exit interview was conducted and a copy of this review was provided.