Pre-licensing visit·September 13, 2024

Licensing Program Analyst (LPA) Michael Cava conducted a Component III and Pre-Licensing Inspection with the applicant representative and facility administrators, Viktorya Hayrapetyan and Irene Plokhova. A Change in Ownership (CHOW) Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on March 27, 2024. The facility is a one story building. A fire clearance was approved on June 30, 2024 for five (5) non-ambulatory and one (1) bedridden, for a total capacity of six (6). Bedroom #4 is cleared for bedridden. Bedroom #5 can either be used for staff bedroom, but is also approved for resident use for ambulatory only. The smoke alarms and carbon monoxide detector are dual and interconnected. The facility has two fire extinguishers, one is located in the kitchen and the other at the hallway by the front entrance. Fire extinguishers were purchased on April 23, 2024. KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There was an adequate supply of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). There was also a sufficient amount of kitchenware for resident use. Knives and are locked in a kitchen drawer. BEDROOMS: The facility has a total of five (5) bedrooms. Rooms #1 and #4 are shared. Rooms #2 and #3 are private. Room #5 is currently designated for staff use, but has a fire clearance for Ambulatory only. The applicant furnished the resident bedrooms with beds, night stand, chairs, dresser, bedding and linen. All five bedrooms have sufficient lighting and closet space. BATHROOMS: The facility has three (3) bathrooms. Two bathroom are for resident use. One bathroom is for staff. Bathrooms designated for residents were observed to have the proper fixtures, grab bars, and non-skid mats. Staff bathroom will be locked and inaccessible to the residents. The hot water delivered in the resident bathrooms measured between 108 and 109 degrees. COMMON AREAS: These included the living room and dining room areas. The living room room was equipped with a couch, love seat, chair table and television. There is a fireplace with a screen and a glass slide. It is non-operational. According to the administrators, the gas is shut off. There were no fireplace tools or fixtures present. The dining area has a large dining room table to accommodate six (6). The floors were mopped and clean. Passageways and hallways were clear of obstruction. The facility has three fire doors installed. One at the dining room and one by the front entrance which leads to resident rooms. LAUNDRY ROOM: The laundry room is located by staff room (room #5). The laundry room will be kept locked at all times. Laundry detergents and cleaning supplies will be maintained in the laundry room. MEDICATIONS/Staff & Resident Records: The medications will be kept locked in a kitchen cabinet. Staff and resident records kept in staff room (room #5) GARAGE: The garage is attached to the home. Entry is at the kitchen. It requires a combination code to gain access. Garage will be used for storage space. 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 backyard of the facility has backyard furniture to accommodate the six (6) residents. The facility backyard has sufficient yard space for leisure and activities. There is a swimming pool that is fenced all around with a gate that will be kept locked at all times. The fence surrounding the swimming pool is approximately 5 feet high all around its parameters. 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.