Pre-licensing visit·August 22, 2023

Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an announced Pre-Licensing visit to this facility and met with applicant Lusine Tadevosyan, Administrator. Currently there are five residents in care. Visit was conducted on 8/22/25. Component three was also conducted on 8/22/23. The visit consisted of a tour of the physical plant. LPA inspected the facility for fire safety, personal accommodations and services, medication procedures, and food service. Facility has four bedrooms. Three bedrooms are shared. There are two bathrooms. Fire clearance is approved for five non-ambulatory residents and one bedridden. LPA observed bedrooms and bathrooms to be clean. Bedrooms had appropriate linens on the beds, appropriate window coverings with screens, and appropriate furniture. Hot water was observed by LPA and administrator at 115 degrees F. The facility smoke alarm system and carbon monoxide is operable. Medications will be locked in a closet. Chemicals and cleaning solutions will be locked and stored under the kitchen sink. All knives and sharp objects will be locked in a kitchen drawer. There are no bodies of water on the premises. LPA toured all common areas. LPA observed home to be clean and furniture to be in good condition. LPA did not observe any obstructions throughout the facility. A telephonic exit interview was conducted, and a hard copy of the report was provided via email for signature. LPA will notify Centralized Application Unit regarding the completion of the pre-licensing visit and the completion of component III,