Pre-licensing visit·May 22, 2025

Licensing Program Analyst (LPA) Michael Cava conducted a Pre-Licensing Inspection with the administrator, Tatevik Aroyan. An Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on January 22, 2025. The facility is a one story building. A fire clearance was approved on March 26, 2025 for five (5) non-ambulatory residents and one (1) bedridden resident, for a total capacity of six (6). The applicant is requesting a hospice waiver to retain six (6) residents. The smoke alarms and carbon monoxide detector are dual and inter-connected. The facility has one new fire extinguisher, located in the kitchen. It was purchased on March 6, 2025. The first aid kit and manual is kept in the medication cabinet. A tour of the physical plant was initiated at approximately 9:45am and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, oven/stove, microwave oven and sink. There were adequate supplies of nonperishable food and dining ware to accommodate a maximum capacity of six (6). Perishable food items not required at this time as there are zero (0) residents. Knives were observed locked in a kitchen drawer. Cleaning supplies observed locked underneath the sink. BEDROOMS: There are four (4) bedrooms designated for client use. Bedrooms #1 has a fire clearance for ambulatory only. Bedrooms #2, #3, and #4 are cleared for non-ambulatory, with bedroom #2 having the bedridden fire clearance (per STD 850). At this time, administrator furnished one model shared room, and one modeled private room. These model rooms were furnished with a with beds, night stand, chairs, dresser, bedding and linen. The bedrooms have sufficient lighting and closet space. BATHROOMS: The facility has two (2) bathrooms. Bedroom #3 has it's own bathroom. The common bathroom is located at the hallway, between bedrooms #3 and #4. Both bathrooms were observed to have the proper fixtures, grab bars and non-skid mats. The hot water delivered in the bathrooms measured between 108 to 110 degrees. COMMON AREAS: This includes the living room and dining room. The living room has two couches and chair. The dining room table is large enough to accommodate six (6). There is also a round table centered between the dining room and kitchen that can seat four (4). There is no fireplace. Furniture and floors were clean and in good repair. Entry, exits, hallways and passageways were clear of obstruction. GARAGE: There is no garage. LAUNDRY ROOM: The laundry room is located by Room #1. Door to laundry room has a lock, and will be kept locked at all times as detergents and cleaning supplies will be kept inside. MEDICATIONS: The medications will be kept locked in a medication drawer located by the living room. STAFF WORKSTATION/STAFF & RESIDENT FILES: There is a small staff workstation across Room #1 where staff and resident files will be kept in a locked cabinet. Work station is equipped with a small printer. SURROUNDING GROUNDS: All entry and exit doors have a functional auditory alert. The backyard of the facility has sufficient yard space to hold outdoor activities when the weather permits. Both the front yard and the patio in the backyard have furniture to accommodate the six (6) residents. There is no swimming pool or any other bodies of water. There is an ADU, that is a separate unit and fenced out, which is not part of the fire clearance (per STD 850) 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 is compliant and ready for licensure. CAB will be advised and a copy of this report provided.