Routine inspection·August 20, 2025

Licensing Program Analyst(LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool. LPA Yee met with Jasmine Sargsyan, Licensee and the reason for today's visit was provided. Arman Sargsyan, Administrator was out of town and did not participate in todays visit.. The facility is a single storey home consisting of a living room, dining room, kitchen, 3 bedrooms, 3 full bathrooms and a attached garage that was converted into a office/living quarters. The facility is fire cleared for 6 non-ambulatory residents only. All 12 domains of the CARE Inspection Tool was reviewed on today's visit. Also reviewed on today's visit were all 5 resident files and 6 staff files. The following was observed on today's visit: the living room, dining room and kitchen were furnished and equipped with the appropriate furniture and equipment for its designated use and for the licensed capacity. The fire place in the front room was observed with a fire screen. The only fire extinguisher is located in the laundry room, located next to the kitchen, was last serviced on 7/29/25. Sufficient perishable foods for a minimum of 2 days and non-perishable foods for a minimum of 7 days were observed. Sharp knives are stored in a locked kitchen drawer continued on LIC809 Soap, cleaning solutions, hygiene products are stored in a locked cabinet in the laundry room. Additional hygiene products are also stored in the common bathroom located by bedroom #3 All three bedrooms were furnished with 2 each of the following: 2 hospital beds, 2 chairs, 2 night stands, 2 lamps, 2 dressers and a shared built in closet.. The common bathroom by the front room has a toilet, a single sink vanity and a tub with a shower. Grab bars, a shower chair and a slip resident mat was observed. Water temperature was tested and read 115.7 degrees Fahrenheit. The common bathroom located by bedroom #3 has a walk in shower with grab bars, shower chair, slip resident mat, a toilet with a riser, and a single sink vanity. Water temperature was tested and read 112.3 degrees Fahrenheit. The third full bathroom located by the front door is designated for staff use. The first aid kit was reviewed and contained gauze, bandages, band aid, a tweezer and a pair of scissors. An external thermometer was also observed. Medications are stored in a locked cabinet in the living room. Oxygen is in use in the home and signs were posted. However, it was suggested that larger signs be posted so it is more visible. Per Licensee, a written notice was sent to the local fire department. The required posters were observed. The garage was also toured and is still being used as an office and for staff use. the hardwired smoke detectors and combination smoke/carbon monoxide detectors located inside the resident rooms, resident hallway and in the dining room were tested and were operational. the auditory devices on the outside exiting doors located in bedroom #3, front door and the 2 sliding glass doors in the living room were tested and were operational. The window screens in bedroom #2 and common bathroom are warped and missing a screen, bedroom #3 is missing a screen and the sliding screen door is warped. Per Licensee, new screens were ordered and the vendor was supposed to replace the screens on 8/19/25 and did not show up as scheduled. Copy of the emailed appointment confirmation was obtained. The Licensee was given 2 weeks(9/3/25) to resolve installation with the vendor and provide evidence of completion. Located in the backyard is a detached covered patio furnished with wicker chairs and a coffee table. The backyard was observed to be clean The front yard was also toured and it was observed to be clean. Trash cans were observed on the curb for pickup for the following day. Exit interview was conducted.