Pre-licensing visit·May 31, 2024

Licensing Program Analyst (LPA) Mariana Agban conducted a Pre-Licensing Inspection with facility Administrator Rena Danileyan and Lincensee Anna Adamyan. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on October 30, 2023. A fire clearance was approved on Jan 29, 2024 for a maximum capacity of five (5) non-ambulatory adults and one(1) Bedridden. Hospice waiver has been requested for six (6) residents which is pending approval of Manager. A tour of the physical plant was initiated at 9:20 am 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) residents. BEDROOMS: There are four (4) bedrooms designated for residents use. Two bedrooms will be designated for shared rooms and the other two bedrooms are private. All bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space. Each bedroom had wearable lanyard emergency/ caregiver call button. LPA observed that the facility sketch indicated that Bedroom 1 and 4 are shared and Bedroom 2 and 3 are private. LPA advised licensee to update the facility sketch and email it to LPA. BATHROOMS: The facility has one (1) main bathroom and one (1) in the private bedroom number #3 for the resident in that room to utilize. Hot water temperature was not with range of 105 to 120. The Licensee stated that a representative from the gas company will fix the issue tomorrow 06/01/24. Common Areas : These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. Laundry Area: The laundry room is located in the kitchen. The washer/dryer appear to be in good condition. Laundry supplies are kept inaccessible in the garage. MEDICATION: The medication will be kept in a locked cabinet located in living area. Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. LPA observed and inspected the detached garage. No hazards observed. Garage is used for storage only. Pre-Licensing is incomplete with deficiencies to be resolved by June 7, 2024 . A follow up Pre-licensure LIC809 will be generated upon resolution of deficiencies CAB will be advised and a copy of this report provided.