Routine inspection·September 10, 2025

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 9:44AM. The LPA met with the Licensee Mariam Panadzhyan and informed them of the reason for the visit. Entrance interview conducted. Beginning at 9:49AM, the LPA and Licensee toured the physical plant areas inside and outside to ensure there were no health and safety hazards, and facility is in compliance with Title 22 Regulations. The following was observed: BEDROOMS/RESTROOMS: There were four (4) total bedrooms: one (1) private resident bedroom and three (3) shared resident bedrooms. Bedrooms #1 and #4 had direct exits to the outside and Bedroom #1 was approved for one (1) Bedridden resident. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Extra linens were stored in a cabinet located in the living room. Additionally, there was one (1) locked staff room that was utilized as an office and contained medications and files. There were four (4) total restrooms in the facility: two (2) common resident restrooms, one (1) private staff restroom, and one (1) private resident restroom. Restrooms were clean, sanitary, and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap, paper products, and displayed hand washing signs. Hot water was tested and measured between 109.6 degrees F and 118.8 degrees F, which is within the required range per regulation. Additionally, the facility measures the water temperatures weekly. Report Continued on LIC 809-C COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. Required postings were observed in the entryway walls. The facility maintained a comfortable temperature throughout the visit. The LPA observed nightlights throughout the hallways. KITCHEN: The LPA observed knives stored inaccessible in the office/staff room. Kitchen appliances were clean and in operable condition. The facility had a supply of perishable and non-perishable food. Food in the refrigerator and freezer were observed to be properly stored with labels and dates. OUTDOOR AREA: The surrounding grounds had a shaded patio area equipped with furniture in good condition for residents and visitor use. The front yard had a driveway with a remote operated gate as well as a door for everyday use. There was one (1) emergency exit located on the side of the facility that was self-latching and led to the front yard. The other side of the facility had a locked shed that contained general storage/equipment. All exits and passageways were free of obstruction. The LPA observed an additional shed in the backyard that contained general storage and emergency food and water. RECORDS: Record review began at 10:21AM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. One (1) staff did not have a health screening and TB test on file. The Staff and Licensee stated it was provided, however were unable to provide the LPA with the documentation. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and reviewed annually as required. Emergency disaster drills are conducted quarterly, with the last documented drill on 07/05/2025. Smoke and carbon monoxide detectors were tested at 10:12AM and were operational. Additionally, the facility tests the smoke and carbon monoxide detectors monthly. Two (2) fire extinguishers were observed and were purchased on 08/16/2025. Report Continued on LIC 809-C MEDICATIONS: Medication review began at 11:50AM. Medications were centrally stored and kept inaccessible. Medications were observed for two (2) residents. Medications were labeled and checked for expiration dates and were properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. Pursuant to Title 22 CA Code of Regulations and/or Health and Safety Code, the following deficiency was cited (Refer to LIC 809-D). Exit interview conducted. A copy of the Appeal Rights and report was reviewed and provided.