Routine inspection·April 16, 2026

On 4/16/26, 9:45 am, Licensing Program Analyst (LPA) Raymond Comer conducted an unannounced annual visit to this facility. LPA met with Facility Administrator, Shake Nilkoghosyan, and reason for the visit was discussed. Facility is licensed as a single-story residence; fire clearance is licensed for five (5) non-ambulatory, and one (1) bedridden; total capacity of six (6) residents. Facility has six total (6) bedrooms, (Bedroom#3 can be used for bedridden) and four (4) total bathrooms; two (2) bathrooms used for residents, and two (2) for visitors/staff use. At 10:10 am , LPA conducted a tour of the physical plant with the Administrator and observed the following: Physical plant: was inspected for cleanliness and conditio n . Facility’s main door is the primary entry/exit access. Visitor Sign-in sheet, hand sanitizer, gloves and masks are available. Hand washing, coughing etiquette, and other necessary signage are posted throughout the facility. Room temperature is comfortable; wall thermostat displays a setting of 71.0°F . , within the required range. Postings are prominently displayed and observed as current. Passageways and entrance was clear of obstruction. All entry and exit doors utilize a functional auditory alert signaling when doors are opened. Disaster drills were last conducted on 3/15/2026. Fire detection system: is present in the facility. Dual smoke\carbon monoxide detectors are wired and interconnected throughout the facility; detectors were tested and functioned properly. LPA observed one (1) fire extinguisher located in the kitchen area; purchase/service Date: 1/13/2026. [LIC 809C] Continued Kitchen: At 10:25 am , LPA observed kitchen as clean, equipped with stove, refrigerator, microwave oven, and multiple appliances. LPA observed an adequate supply of perishable and non-perishable foods as properly labeled and stored. Kitchen cabinets store dishes, plastic, paper goods and utensils. Knives and sharps are stored and locked in a kitchen drawer and are inaccessible to residents. Medications: were observed stored in a locked kitchen cabinet, which requires a magnetic key to access; inaccessible to residents. Facility has fully stocked first aid kit and manual. Laundry: LPA observed the laundry area located inside a closet hallway, near the staff bathroom. Laundry soaps, and other cleaning agents are secured in the staff bathroom and inaccessible for residents. Linen storage observed maintaining an adequate supply of linens and towels. washcloths and towels are not shared. Garage: There is no garage at the facility; car port is located by facility's entrance. . Commons: LPA observed common areas (living room, dining room) to be clean, organized, furnished and in good condition. Dining room table and seating is sufficient for all residents and staff. Bedrooms were observed as clean, with sufficient closet space, lighting, properly furnished with bedding, linens, dressers, at least one chair, night stand and call pendants. Bathrooms were observed to be clean and sanitary with necessary supplies and required safety fixtures (grab bars, anti-slip floor stripping). Hot water temperature measured at 109.0°F. Within the required range. Outdoor (backyard) area observed to have a shaded patio, with table with sufficient seating for the residents. Outdoor furniture observed to be in good condition. Outdoor area observed as clean and clear from obstruction. No bodies of water are located on the premises. Resident records: Records were stored in a file cabinet located in the dining room area; LPA observed cabinet as locked and inaccessible to residents. A total of six (6) resident files were reviewed for current IPP and/or Needs and Services plans, physician report, admission agreements and other related documentation; Resident records appeared to be complete and current. [LIC809C] Continued- Staff records: Records were stored in a file cabinet located in the living room area; LPA observed cabinet as locked and inaccessible to residents. A total of five (5) Staff files were reviewed. Criminal record clearances, CPR, Health Screenings, and all other required staff documents were reviewed; Staff records appear to be complete and current. There were no immediate health and safety hazards observed at the time of this inspection. Exit interview was conducted and a copy of this report was provided to the Administrator.