Pre-licensing visit·June 16, 2025

Licensing Program Analyst (LPA) Mariana Agban conducted a Pre-Licensing Inspection with Administrator Mariam Panikyan. An Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on February 13, 2025. LPA conducted a physical plant tour and observed that the provided facility sketch doesn't accurately reflect the actual facility rooms. LPA observed and inspected 4 bedrooms. Nevertheless, the facility sketch included a 5th bedroom. LPA was informed that a new facility sketch will be submitted to the Centralized Application Bureau (CAB) to update facility records. LPA tested the smoke alarms and carbon monoxide detectors which were battery-operated and functional. The facility has fire extinguisher with a purchase date of 11/21/2024. The fire extinguisher is located in the dining room area. A tour of the physical plant was initiated at approximately 09:45 am, and the following was observed: KITCHEN : The facility has a Kitchen area equipped with a refrigerator, microwave oven, and sink. Adequate supplies of perishable and nonperishable food and dining ware accommodated a maximum capacity of six (6). Medications will be kept locked in the kitchen cabinets BEDROOMS : There are four (4) bedrooms designated for residents' use. Bedrooms #1 and #4 will be used as private rooms. Bedrooms #2 and #3 will be used as shared rooms. Bedroom#2 is a shared room with one (1) bedridden resident as per the fire clearance approval. The applicant furnished the resident bedrooms with beds, nightstands, chairs, dressers, bedding, and linen. The bedrooms have sufficient lighting and closet space. (Continue on 809C) BATHROOMS: The facility has two (2) bathrooms for the residents' use. Both bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured 109.7 and 110.3 degrees. No cleaning supplies or hazardous items were present in each bathroom. COMMON AREAS: These included the living room and dining room. The living room was equipped with furniture, a television, tables, and chairs. The dining area has a large dining room table to accommodate six (6). There is a fireplace in the family room. It is screened, and there are no tools. There were no visible immediate hazards. There is a functioning telephone on the premises in the dining room. There is also an office/workstation area in the dining room where residents and staff files will be locked in. LAUNDRY ROOM: LPA observed the washer and dryer to be in good repairs. Laundry room door was locked and thus laundry detergents are kept locked and inaccessible to residents. GARAGE: The garage is used as extra storage for non-perishable and emergency food supplies and water. There is another refrigerator in the garage for additional perishable food items. SURROUNDING GROUNDS : The driveway, passageways, and entrance to the home were clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The backyard of the facility has a patio and backyard furniture to accommodate the six (6) residents. The facility's backyard has sufficient yard space. In addition to the Pre-Licensing inspection, a Component III power point presentation was also held. Pre-Licensing is incomplete . Licensee will submit a new facility sketch to Centralized Application Bureau (CAB ). Exit interview conducted and report signed and issued.