Pre-licensing visit·July 2, 2025

On 07/02/25, at 09:35am, Licensing Program Analyst Gina Saucedo conducted an announced Pre-licensing visit. LPA met with Administrator, Hasmik Atshemyan at 9:35am. An application was submitted to Community Care Licensing Division-CCLD on 02/25/2025, Initial license for a Residential Care Facility for the Elderly (RCFE), 60 years and older. The requested capacity is for six (6) non-ambulatory and one (1) maybe bedridden, total of up to six (6) residents and fire clearance was approved on 04/22/2025. Structure: The facility is a single-story building with four (4) bedrooms and two (2) bathrooms. One (1) of the bathrooms is in one (1) of the bedrooms and the other bathroom is in the hallway. Entrance: There is only one (1) entrance being utilized. Required postings such as: Ombudsman, Personal Rights of Residents, Rights of Resident by Council, Family Council, Emergency and Disaster Plan, Theft and Loss, Non-discrimination Policy and YES are posted against the walls of the facility. Toxins, cleaning solutions, and laundry detergents will be kept locked under the sink in the kitchen inaccessible to residents. Living/Dining area: The living room is neat, clean, and organized with sufficient seating for both residents and staff. The dining area is also neat, clean, and organized. Both areas are properly furnished and in good repair. The facility maintains a comfortable temperature of seventy-five (75) degrees. No firearms observed or will be maintained on the premises. There is a working telephone on the premises. LIC809C-continued Resident/staff files: Resident and staff files will be kept locked in a filing cabinet in the kitchen area. Kitchen: Sufficient supplies of dishes, cups, and silverware located within the kitchen cabinets and drawers. Sharps are stored on the left side of the kitchen locked and inaccessible to the residents. Kitchen appliances are working and are in good repair. There is a working telephone on the premises. Emergency: Fire extinguisher located in the kitchen on the right side and dated 02/2025. Medications: Medication will be stored in a cabinet in the kitchen area locked and inaccessible to the residents. First-aid kit will also be kept in this area. There is a small refrigerator that will also be kept in the kitchen area for cold and/or syringes that will also be locked and inaccessible to the residents. Bedrooms: The bedrooms are properly furnished with bed, nightstand, applicable lightening, and seating. Window coverings are in good repair, not broken or damaged. Bathroom: The bathrooms are in proper condition and will be equipped with sufficient personal hygiene for each resident. Hallways: Hallway is properly lighted. The washer and dryer are located in the hallway locked and inaccessible to the residents. Staff room: there is no designated staff room in the facility at this time. Water Temperature: The water temperature was measured in the bathrooms at 113.2 Fahrenheit and is within regulations. LIC809C-continued Smoke detectors: Dual interconnected smoke detectors and carbon monoxide observed to be working properly and were tested. There are also egress doors. Garage: The garage is located outside separate from the facility and is currently being utilized for storage. Outside: The outside is clean, free of hazards, and will be properly furnished with sufficient seating. A shaded area for residents was observed as well. Pool: no bodies of water located at the facility. Administration: The facility had submitted an Emergency and Disaster Plan For Residential Care Facilities For The Elderly and Infection plan. The Component III Orientation RCFE-Residential Care Facilities Elderly was shown/reviewed with the Administrator. Facility is in compliance with Title 22 Regulations at this time. This report will be forwarded to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. Exit interview conducted and copy of this report issued to the administrator.