Pre-licensing visit·June 4, 2025

At 9:00am, Licensing Program Analyst (LPA), Angela Panushkina conducted an announced Pre-Licensing visit to the above facility and met with the Administrator - Lusine Tadevosyan and the Licensee - Sergey Azaryan and explained the reason for the visit. An application was submitted to Community Care Licensing Division (CCLD) for a Residential Care Facility for the Elderly (RCFE) to serve age range 60 and over. Fire Clearance approved on 01/22/2025 for five (5) Non-ambulatory where one (1) can be Bedridden in rooms #5 or #6. Dementia and Bedridden Plans are submitted. Emergency numbers are posted and readily available for review. Facility is a single-story home consisting of six (6) bedrooms and four (4) full bathrooms. There are six (6) private bedrooms designated for resident’s use. Facility will have live-in staff. LPA observed that all bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. Facility maintains a temperature of 68°F At 9:10am LPA observed all bathrooms are clean and in good repair. All bathrooms have a working toilet, wash basin and a shower. Properly supplied with toilet papers, soap and paper towels. At 9:20am, the hot water temperature measured at 120.0°F. All trash cans in bathrooms had fitted lids to protect from cross contamination. At 9:30am, LPA observed a Fire Extinguisher which was last purchased on 01/10/2025. Dishes, cups, and flatware are stored in the kitchen cupboards, inspected and in good condition. Knives were observed locked in the kitchen drawer. The first-aid kit has been inspected which has at least the following: tweezers, scissors, antiseptic, bandages, gauze, thermometer; including a current First Aid manual. LPA also observed medication cabinet in the kitchen kept locked and inaccessible to residents in care. Continue on LIC809-C Resident and staff files will be kept in a locked, metal cabinet by the computer desk, located in the living room area. Adequate supplies of two (2) days perishable and seven (7) days nonperishable foods, and dining ware to accommodate a maximum capacity of six (6) residents were available. Refrigerator, oven, microwave, dishwasher and washer/dryer were observed to be in good/working condition. The residence is equipped with central heating and air conditioning. Cleaning supplies, and toxins are locked under the kitchen sink and in the garage/laundry area and only accessible to staff. Smoke detectors and carbon monoxide were tested at 10:00am and observed to be functional. At 10:05am, LPA observed sufficient yard space with fenced backyard. The outdoor area was free of visible immediate hazards. There is a swimming pool that is fenced to keep residents out of the swimming pool area. The fence is approximately 5 feet high throughout the parameters. You will need a key to unlock the padlock to gain entry to the swimming pool as it is kept locked at all times. LPA discussed the importance of maintaining the care and supervision to meet the needs of residents. Component III was conducted at 10:20am. Pursuant to Title 22, Division 6 Chapter 2, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised, and a copy of this report will be emailed. Exit interview conducted and copy of this report signed and delivered