Routine inspection·December 12, 2025

At 10:00 AM Licensing Program Analyst (LPA), Nadia Shahbazian conducted an unannounced annual inspection at the facility. LPA met with the administrator, Narine Hannesyan and informed her of the reason for the visit. Facility is licensed to serve 6 non-ambulatory residents over the age of 60, of which 1 maybe bedridden. Facility has a hospice wavier for 3. At the time of inspection facility census is 5. Facility is a single story house, located in a residential neighborhood, consisting of a living/dining room, kitchen, 4 bedrooms, 1 staff bedroom, and 2 bathrooms. At approximately 11:00 am LPA conducted a physical plant tour and observed the following: Common Areas : Required postings were observed posted on the entry hallway. The entry hall was furnished with a dresser, which included a complete first aid kit and a first aid manual. The living room and dining area is a large space, with the office space in the corner of the dining room. The living area appeared to be clean and was properly furnished with seating for the capacity of the facility. LPA observed a screened fireplace in the living room, in addition there are games, magazines, television, telephone, cable and internet access. There is a refrigerator in the dining area with a fire extinguisher on top. The fire extinguisher was purchased on 01/08/2025. There is a locked, non-functional sliding door in the dining area. Kitchen : LPA observed a refrigerator, stove, microwave oven, toaster over, dishwasher and all the appliances were functional. Sharp objects were locked in a drawer in the kitchen and cleaning solutions and detergents were locked in a cabinet. There is a large supply of dishes in the cabinets. Facility has perishable foods for two (2) days in the refrigerator and a supply of non-perishable foods for seven (7) stored in pantry and cabinets. All kitchen work surfaces, floors and walls were maintained in sanitary and clean condition. Continued on LIC 809C Bedrooms/Bathrooms: The facility has five (5) bedrooms in total. The staff uses one of the bedrooms as sleeping quarter, but there is always awake staff in the facility. Bedroom #4 has a fire door and an exit door. There is an additional fire door in the hallway leading to bedrooms #1 through #3. Bedroom #2 has it's own full bathroom and there is another full bathroom between bedrooms #1 and #2. The water temperature in the bathroom was measured at 107.6 degrees Fahrenheit. All bedrooms contained a chair, night stand, dresser, lamp, and beds with adequate bedding. Surrounding Grounds : The main entry door is used for the emergency exit. There is another exit gate in the front, which was kept unlocked and the path was free from debris. There was a fenced pool in the backyard, which is kept locked. The garage has been converted to a dwelling and is privately occupied. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. All walkways and exit passages were free of obstruction. There are two locked sheds in the backyard, one is used for storage and the other locked shed is where the washer and dryer and the laundry detergent/chemicals were kept, inaccessible to residents. Smoke detectors/carbon monoxide . Carbon monoxide detectors and smoke detectors were located throughout the facility but were not interconnected. At 12:05 PM, smoke detector and carbon monoxide detectors were tested and observed to be operational. Staff/Resident Files : The resident and staff files are kept locked in the staff bedroom. LPA conducted a file review of records for three staff, to ensure compliance of licensing forms and training. Records for all 5 residents were also reviewed and medications for 2 residents were counted and compared for accuracy of administration. Pursuant to Title 22 Division 6 of the CA Code of Regulations, Technical Advisory-deficiencies cited. Exit interview conducted. Appeal rights and copy of report provided to administrator.