Pre-licensing visit·April 17, 2025

Licensing Program Analysts (LPA) Nadia Shahbazian conducted an announced Pre-Licensing Inspection with Marine Karapetian - Administrator/Licensee at 1:00 pm. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 10/01/2024. Facility's fire clearance is approved for five (5) Non-ambulatory residents and one (1) bedridden resident, for a total capacity of six. Bedroom #1 is appropriated for bedridden resident. The smoke alarms and carbon monoxide detectors are dual and inter-connected. In addition, facility is equipped with two (2) fire doors, near the front entry and bedrooms. The facility has a fire extinguisher purchased on 03/05/2025. Fire extinguisher is located near the dining room exit door. With the assistance of the administrator, a tour of the physical plant was initiated at 1:30pm and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, stove, oven, microwave oven and dishwasher. There was an adequate supply of non-perishable food items observed. Perishable food items are not required at this time as there are no residents. Administrator was advised facility needs to carry perishable food items once they admit residents for care. Knives were observed locked in a kitchen drawer. LAUNDRY AREA: The laundry area is located on the side of the kitchen, with a exit door leading to the backyard. Cleaning supplies, detergents and chemicals were observed to be kept in cabinets in laundry area. BEDROOMS: There are four (4) bedrooms, three bedrooms will be used for residents and one bedroom for staff. Bedroom #4 is currently utilized as the staff bedroom/office. Bedroom #1 is designated for the bedridden resident and has an exit door. Each bedroom was furnished with beds, chairs, dresser drawer and closets, bedding and linen. The bedrooms have sufficient lighting and closet space. There is a two-sided non-functional fireplace in bedroom #4. The fireplace is properly screened on both sides, the other side of the fireplace is located in the living room. Continued on 809-C BATHROOMS: The facility has two (2) bathrooms. Bedroom #1 has it's own bathroom with shower. The other bathroom is located by bedrooms two (2) and three (3). The bathrooms were observed to have the proper fixtures, grab bars, non-skid maths and shower chairs. Hot water delivered in the bathrooms measured at 107.4 degrees Fahrenheit. COMMON AREAS: These included living room and dining rooms. The dining room has a table large enough to seat six (6) residents. The living room two side tables and a television set. There is a two-sided non-functional fireplace in the living room, properly screened. The other side of the fireplace, is located in bedroom #4. There is a gaming area in the living room and a library by the front hallway. Facility is equipped with cameras in common areas. MEDICATIONS: Medications will be kept locked in kitchen cabinets. There is a locked small refrigerator dedicated for medication usage, in the kitchen. There is a complete first aid kit and first aid manual, locked in the kitchen cabinet. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. The backyard of the facility is large enough to hold outdoor activities. Backyard furniture was observed placed underneath a covered patio. There is no swimming pool or body of water. There is a detached garage, currently used as storage. There is an exit door in the dining room, an exit door in bedroom #1, both leading to the backyard. The main entry door will be used as the emergency exit door. All gates leading to the backyard were free of obstruction and had clear pathways. OFFICE/STAFF WORKSTATION: Bedroom #4 is currently utilized as the staff room/office. The staff room is furnished with a sofa, chairs, desk and a workstation consisting of filing cabinets to store resident and staff records. Facility is equipped with internet access, cable and land line telephone. LPA observed all the required postings displayed in the office area. In addition to the Pre-Licensing inspection, a Component III power point presentation was also 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.