Routine inspection·June 16, 2025

On 06/16/2025 Licensing Program Analyst (LPA) Evelin Rios, arrived to the facility listed above to conducted an unannounced annual visit. Upon arrival LPA was greeted and granted access by the administrator, Serop Sarkisyan. LPA explained the reason for the visit. In the facility LPA observed six (06) residents and four (04) staff. This is a Residential Care Facility for the Elderly vendored by Lanterman Regional Center. At approximately 1:33 p.m., LPA conducted a physical plant tour of the facility and observed the following: At entrance by the office area LPA observed appropriate postings such as personal rights, the facility's Emergency Disaster Plan and Personnel Report (LIC 500). Common Areas: These include the living and dining area. The living room and dining area were observed clean and clear of clutter. The facility maintains a comfortable temperature at 76°F. LPA did not observe any tripping hazards. The furniture was observed clean an in good repair. Seating was sufficient for the capacity of the facility. Bedrooms: LPA observed a total of six (06) bedrooms designated for residents' use. Resident bedrooms are private. Resident bedrooms were observed properly furnished with appropriate beds, night stands and chairs. LPA observed sufficient storage and lighting for residents. Bathrooms: There are two (02) bathrooms designated for residents' use. Bathrooms were properly supplied and had functional fixtures. At 1:55 p.m., LPA took the hot water temperature from one (01) out of two (02) bathrooms and it measured 108 degrees Fahrenheit, within regulation. (continued on LIC 809-C) Outside/Surrounding Grounds : LPA observed that the entry/exits were free of obstruction. There is a shaded area for residents to use. The backyard is sufficient in space for outdoor exercise and activities. LPA observed greenery that provides shade for the residents. The facility has a detach garage. Garage is not accessible to residents. Food Service/Kitchen: In the kitchen LPA observed the kitchen to be clean and clear of clutter. Appliances and fixtures were functional. LPA also observed a 7 day supply of non-perishable amount of food and a 2 day supply amount of perishable food in the facility. Dual smoke/carbon monoxide detector are hardwired and interconnected, and were tested by the administrator at 1:58 p.m. and observed to be operational. There is a fire extinguisher in the facility located in the kitchen. Fire extinguisher was observed to be fully charged with purchase date 05/19/2024. Staff records : At 2:12 p.m., LPA reviewed five (05) staff files for compliance and current training. Staff records were observed complete and up-to-date. LPA reviewed facility records and observed the facility had an earth quake drill on 05/01/2025, fire drill on 06/01/2025 and last reviewed their Infection Control Plan on 03/01/2025. Resident records : Six (06) of six (06) resident records were reviewed and observed to be complete and up-to-date. Medications : LPA observed medications were locked and kept in a hallway cabinet inaccessible to residents. Facility also keeps a Medication Administration Record (MAR). MAR documents the medications being centrally stored. There is a complete first aid kit located in the medication cabinet. No deficiency cited during today’s visit. Exit interview conducted and copy of this report provided.