Pre-licensing visit·May 20, 2025

Licensing Program Analyst (LPA) Michael Cava conducted a Pre-Licensing Inspection with the CEO Samvel Darbinyan, and the administrator, Shushanik Vardanyan. An Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on February 26, 2025. The facility is a one story building. A fire clearance was approved on April 9, 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 April 1, 2025. The first aid kit is maintained at the check in station located by the front entrance. 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. BEDROOMS: There are four (4) bedrooms designated for client use. Bedrooms #1 and #4 are shared rooms, with bedroom #1 having the bedridden fire clearance (per STD 850). Bedrooms #2 and #3 are private rooms. Resident bedrooms were properly furnished with beds, night stand, chairs, bedding and linen. Each bedroom has sufficient lighting and closet space. BATHROOMS: The facility has one and one half (1 1/2) bathrooms. Bedroom #4 has the half bath with only a toilet and sink. The common bathroom is located at the hallway, across from bedroom #2 and #3. Both bathrooms were observed to have the proper fixtures and grab bars. The common bath had a non-skid mat. The hot water delivered in the bathrooms measured between 105 to 106 degrees. COMMON AREAS: This includes the living room and dining room. The living room has a large L- shaped couch, coffee table and television. The dining room table is large enough to accommodate six (6). There is no fireplace. Furniture and floors were clean and in good repair. Entry, exits, hallways and passageways were clear of obstruction. GARAGE/LAUNDRY ROOM: The garage is attached to the home. Garage will be used as storage for cleaning supplies and laundry area only. Garage will be made inaccessible at all times. MEDICATIONS: The medications will be kept locked in a kitchen cabinet. STAFF/RESIDENT FILES: Staff and resident files will be kept at a locked filing cabinet near the living room. SURROUNDING GROUNDS: The driveway and entrance of the home was clear and maintained. 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. The administrator will be furnishing the backyard with some patio furniture. There is no swimming pool or any other bodies of water. Passageways through the side and side gates were free of obstruction. 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.