Routine inspection·February 25, 2025

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Adranik Ter-nersesian and staff, Sirun Harutyunyan and explained the reason for the visit. At approximately 11:15am, with the assistance of staff, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms and carbon monoxide are dual, are hardwired and interconnected. The facility is equipped with a fire door and sprinkler system. All doors are equipped with auditory alarm. The fire extinguisher is located at the staff workstation, located by the kitchen and front entrance. The charge date is 10/25/24. LPA observed two complete first aid kits during the inspection. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Properly labeled medications were locked in one of the kitchen cabinets. Bedrooms: There were four (4) bedrooms designated for residents' use. Two bedrooms are shared rooms and two bedrooms are private. All four bedrooms were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are two (2) bathrooms. One (1) bathroom is designated for staff. Bathroom designated for resident use is properly supplied and had functional fixtures. Hot water temperature was measured at 110 degrees Fahrenheit. No cleaning supplies observed accessible in the bathroom during the day's inspection. Common Areas : These included the living room and dining area. The living room/common area is observed with four recliners and a couch. There are two medium sized dining room table, fit to seat four (4) individuals on each table. There is a fireplace, that is covered. Fireplace is non-operational. No fire-place tools present. Surrounding Grounds : Passageways along the entrance, sides and back of the home were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. There is no swimming pool or any other bodies of water. The laundry area is located outside of the home, at the side, opposite the kitchen. Both washer and dryer were covered and not in use at the time. LPA did not observe any cleaning supplies. Office/Staff Workstation: The staff workstation is located near the kitchen, at the front entrance. Resident Files : LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files : LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications : Medications are kept in a locked cabinet in the kitchen. Medication and Medication Records were review for proper storage and documentation. Client insulin observed in a locked case in the refrigerator. The disposable container, where the used needles are disposed of, is kept locked in the medicine cabinet. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a copy of this Report Issued.