Routine inspection·September 14, 2025

Licensing Program Analyst (LPA) Jose Tan conducted an Annual Required inspection of this facility today. LPA met with the House manager, Serge Petrosian and explained the reason for the visit. Per the house manager, they never had any client since opening and currently applying for vendorization at the North Los Angeles Regional Center (NLARC) Level III RCFE. A tour of the physical plant was conducted at 9:39 AM and the following was noted: There is only one entrance being utilized at the facility. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Infection Control and Mitigation plan. The facility is fire cleared for six (6) non-ambulatory residents one (1) for may be bedridden in room #1. Facility was also approved for a Hospice waiver for six (6) residents. The facility is a single storey building and has four (4) bedrooms and two (2) bathrooms currently with no residents. The facility dual smoke/carbon monoxide alarm system are hard wired and interconnected, tested and observed to be operational. The fire extinguisher is located by the dining area and was observed to be fully charged and last purchased on 09/14/25. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility and properly stored. Knives were stored in a locked drawer . Bedrooms: All four resident rooms were properly furnished with appropriate beddings and linens with sufficient lighting. (continued on LIC 809-C) (continued from LIC 809) Bathrooms: The bathrooms for the residents were observed to have grab bars, non-skid mats and properly supplied with hygiene products. Hot water temperature was measured at a range of 115.2°F to 117.5°F. LPA did not observe any toxins or cleaning supplies in any of the bathrooms during the day's visit. Common Areas : These included the living room and dining area. The common areas were properly furnished. The dining room area and table is large enough to accommodate up to six (6) residents. The auditory alarms on all exit doors were on and functional at the time of the visit. The fireplace is non-operational and there was a glass and screen door in place. Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The laundry area is located in bedroom hallway and was locked at the time of the visit. Detergents and cleaning supplies are kept in a bedroom hallway cabinet, locked and inaccessible. Garage: There is no garage at the facility only drive way. This driveway leads to two (2) additional dwelling unit (ADU) with a separate address, the ADUs gate was locked and has no access from the facility. Laundry Area: LPA observed the laundry area is located by the living room. Laundry detergents, cleaning agents and other toxins were kept in the locked cabinet in the bedroom hallway. Medications : Medications will be kept in a locked cabinet in the bedroom hallway. There are two (2) complete first aid kits located in the medication closet. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.