Routine inspection·April 8, 2026

Licensing Program Manager (LPM) Mary Flores and Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA met with staff, Marissa Flores, and explained the reason for the visit. Approximately, around 9:00 AM licensee, Edgar Ghazaryan, arrived and was explained for the reason of the visit. At 9:02 AM, with the assistance of licensee, LPM and LPA took a tour of the physical plant. Required postings were observed in the entry area. At 9:41 AM the smoke alarms were tested and are operational that are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the kitchen. The charge date is 10/22/2025. During the visit the facility is at 75 degrees Fahrenheit. The facility is fire cleared for five (05) non-ambulatory clients and one (1) bedridden. All rooms cleared for non-ambulatory. Bedroom 1 and 6 cleared for bedridden but only one (1) at a time. Hospice waiver for six (6). Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the garage. Continue to LIC 809-C Bedrooms: There were six (6) bedrooms designated for residents' use and staff. Bedroom #1, bedroom #2, bedroom #3, bedroom #4, bedroom #5, and bedroom #6 are all private. Bedroom that are in used by residents were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. During physical plant tour LPM and LPA observe that bedroom #3 and bedroom #5 has full bed rails installed for resident #3 (R3) and residents #4 (R4), residents are not in hospice, but in home health. Deficiency will be cited in LIC 809-D. Bathrooms: There are three and a half (3.5) bathroom designated for residents' and staff use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 110.3 degrees Fahrenheit for bathroom #1 located in the hallway beside room #1. Bathroom #2 is inside bedroom #2. Hot water temperature was measured at 113.8 degrees Fahrenheit. There was enough clean linen available in the cabinets in the hallway. Bathroom #3 is in the living room. Hot water temperature was measured at 110.3 degrees Fahrenheit. Half (0.5) bath is located beside the dining room that is only for staff use. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for four (4). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Furniture in common area was observed to be in good repair. There are no issues with Fire Clearance. Infection control : Facility mitigation plan to make sure licensee was following current infection control recommendations. LPA obtain a copy and reviewed the infection control plan during this visit. Surrounding Grounds : Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility does not have a swimming pool or body of water. The garage attached and is used for storage and laundry. Laundry service: There is enough linen available to change weekly or more if need. Cleaning supplies are being stored in a locked cabinet in the laundry area. Laundry area and is located in the lock attached garage. Continue to LIC 809-C Staff Files : LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. During record review it was observe that S3 has total a of only 10 hours instead of 20 hours for 2026, majority of S3 training is on 2024. A technical violation (TV) is issued. Medications : Medication and Medication Records (MMR) were review for all residents for proper documentation. Resident records were reviewed for requirements and legibility: Planned activities are offered. Facility is within CA code of Regulations Title 22 or Health and Safety Code. Deficiencies were found, exit interview conducted, copy of report has been issued and discussed.