Pre-licensing visit·April 17, 2024

Licensing Program Analyst (LPA) Michael Cava conducted a Pre-Licensing Inspection with the administrator Nelli Berberyan. An Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on October 5, 2023. A fire clearance was approved on March 22, 2024 for six (6) non-ambulatory for a total capacity of six. The applicant is also requesting a hospice waiver to retain six (6) residents. The smoke alarms and carbon monoxide detector are dual, hard wired and inter-connected. The facility has one new fire extinguishers that was purchased on April 15, 2024. The fire extinguisher is located by the kitchen. A tour of the physical plant was initiated at approximately 9:15am and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). Knives were observed locked in a kitchen drawer. In addition to the non-perishable (canned foods), the applicant has two buckets of an emergency food supply, good for about twenty years. BEDROOMS: There are four (4) bedrooms designated for client use. Bedroom #1 and #4 are shared rooms, Bedrooms #2 and #3 are private rooms. The applicant furnished the resident bedrooms with beds, night stand, chairs, dresser, bedding and linen. The bedrooms have sufficient lighting and closet space. BATHROOMS: The facility has three (3) bathrooms. Bedroom #4 has it's own bathroom. One bathroom is located in the hallway, across from bedroom #1 is for staff and visitors only. Another bathroom, reserved for the resident's use, is located in the hallway, across from bedroom #3. The bathrooms reserved for resident's use were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured at 105 degrees. COMMON AREAS: These included the livint room/ tv, activity room, and dining room. The living room is observed with brand new furniture (couches and table), and a television. There is no fireplace with a screen and a glass slide. The activity room is located adjacent to the dining area. Chairs, tables, ping pong table and sufficient board games were observed. The dining area has a large dining room table to accommodate six (6). There were no visible immediate hazards. LAUNDRY ROOM: The laundry room is located by the garage. It was observed with a locked door requiring a key to gain access. The washer/dryer are brand new. MEDICATIONS: The medication cabinet is located in the kitchen. It has a locking mechanism. First aid kit and first aid manual is also maintained there. OFFICE/STAFF WORKSTATION: Staff workstation is located at the corner of the activity room. Resident and personnel files will be maintained in a locked filing cabinet there. GARAGE: The garage is attached to the building, located adjacent to the laundry room. It is used as extra storage space. No resident access there as there is a locked door to gain entry through the laundry room, to get to the garage. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The left side of the home and backyard of the facility has no access to the residents. There is an ADU on the left side of the facility, that has it's own private entrance, leaving no accessibility to the residents. The exterior, right side of the facility is for resident use only. It was observed with outdoor furniture and has sufficient yard space. In addition to the Pre-Licensing inspection, a Component III power point presentation was held. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised and a copy of this report provided.