Routine inspection·April 20, 2022

Licensing Program Analyst(s) (LPA) Mary Flores conducted an unannounced annual visit at the facility with focus on infection control, food and medication review. LPA Flores met with Susanna Babayan Caregiver and explained the reason for the visit. Administrator arrived 10 minutes after. Facility is licensed for six (6) non-ambulatory clients age 60 and above, of which six (6) may be bedridden in rooms #1, #2, and #3. Facility is approved for one (1) hospice waiver. Facility is a single home located in a residential area, has a kitchen, dining room, living room, 5 resident bedrooms, 2 bathrooms, a front and back yard, and a detached garage. No large bodies of water were observed. LPA Flores conducted a tour of the facility with Karine Filikyan administrator and observed the following: Kitchen area - facility has sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables. Medication was observed in drawer across from the stove, cleaning supplies under sink, and cooking knives in drawers to the left of the sink unlocked at the time of the visit. Fire extinguisher was observed on the wall in the kitchen doorway. Living room was observed to have a cover fireplace. All bedrooms have sufficient lighting, all bedding and furniture required. Bathroom #1(B1) and #2(B2) was observed with grab bars and skid mats, water was tested in B1 at 124.9 degrees F., and B2 at 124.4 degrees F., which is not within the required 105-120 degrees F. LPA reviewed medication and files for 5 residents and flies for staff #1,#2,#3. Exit door to street, exit doors in living room and residents room with access to backyard were observed and no auditory device was heard or observed. Administrator certificate was observed for Karine Filikyan #6024067740 expiration date 1/21/21, per administrator renewal documents have been submitted and is waiting for certificate. LPA has noted technical assistance regarding infection control recommendations. Deficiencies have been noted on LIC 809D under Title 22 Regulations. Exit interview was conducted with Karine Filikyan administrator and a copy of this report, LIC 809D and appeal rights were provided.