Routine inspection·December 18, 2025

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 01:40PM. LPA was greeted at the door by staff and the reason for the visit was explained. The Administrator, Galina Melkonyan arrived shortly thereafter. Entrance interview conducted. At 01:45PM, the LPA along with staff, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN: The LPA inspected the kitchen/food service area at 01:45PM. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for expiration dates and food labels had expiration date clearly marked. Knives and chemicals were locked inaccessible in the kitchen cabinet. Fire extinguisher was located by the kitchen area and was last purchased on 10/03/2025. BEDROOMS: There are six (6) private resident bedrooms. The LPA observed resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. The facility has one common area between Bedroom #4 and Bedroom #5 that is used as a staff room. All direct exits were clear, and no obstructions were noted. RESTROOMS: There are four (4) restrooms of which two (2) are for resident-use, one (1) is for staff-use, and one (1) is for visitors and staff by the common area. Restrooms were clean, sanitary, and in operating condition with grab bars and slip-resistant surfaces. Report Continued on LIC 809-C Hot water temperatures were measured in restrooms and were between 111.2-116.8 degrees F, which is within the required range. At 01:55PM, LPA observed a razor/trimmer in the restroom near Bedroom #5. Staff stated the razor belongs to Resident #1 (R1). Upon record review, LPA observed that R1’s physician’s report signed and dated 10/03/2025, documents that R1 would be at risk if allowed access to personal care and hygiene items as well as sharp objects. Administrator stored the razor locked and inaccessible. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. There is one (1) fireplace which was observed adequately screened. The facility maintained a comfortable temperature. At 02:08PM, smoke detector(s), carbon monoxide detector, and fire doors were tested and were operational at the time of the visit. Auditory exit alarms were functioning at the time of the visit. The LPA observed required postings throughout the common spaces. OUTDOOR AREA: The backyard has a covered outdoor area equipped with furniture for client use. There is a side gate which was observed to self-latch. No bodies of water noted. The washer and dryer appeared operational and are located in the garage. RECORD REVIEW: Beginning at 02:12PM, LPA reviewed three (3) out of three (3) resident files and three (3) personnel files for documents including but not limited to: medical records, care plans, resident Admission Agreement, TB test, health screening, staff training and fingerprint clearance. All resident and personnel files were in order. MEDICATION REVIEW: At 03:20PM, LPA reviewed medications for one (1) resident. Medications are centrally stored and locked in the kitchen cabinet. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs have physicians order on file. Medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today's visit, LPA reviewed the facility's infection control policy as well as the emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster plan is updated annually as required. Emergency drills are conducted quarterly as is required, with the last drill conducted on 10/20/2025. The following deficiency was observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Administrator was informed that failure to correct the deficiency may result in civil penalties. Exit interview conducted. Appeal rights and a copy of the report were provided.