Pre-licensing visit·August 22, 2025

Licensing Program Analyst (LPA) Jose Tan conducted an announced Pre-Licensing Inspection with the applicant representative and Administrator Lilit Hovhannisyan and Harutyaun Aghababyan. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 02/25/25. A fire clearance was approved on 06/05/25 for six (6) non-ambulatory residents, one (1) of which maybe bedridden on Room #1. The applicant will also be requesting a hospice waiver to retain three (3) residents. The smoke alarms and carbon monoxide detector are dual and inter-connected. The facility has a brand-new fire extinguishers located in the kitchen and hallway and last purchased on 04/14/25. At 9:23 AM, with the assistance of the administrator and applicant representative, a tour of the physical plant was in and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, stove/oven, microwave oven and sink. There was an adequate supply of non-perishable food items observed. Perishable food items not required at this time as there are no residents. Administrator was advised facility needs to carry perishable food items once they admit residents for care. Knives were observed locked in a kitchen cabinet. Cleaning supplies observed locked underneath the kitchen sink. BEDROOMS: There are four (4) bedrooms designated for client use on two (2) shared and two (2) private use. The bedrooms were observed to have appropriate furniture and sufficient lighting. There is an additional bedroom and bathroom on the second floor exclusively for the licensee/administrator. The stairs leading to the second floor is gated both on the ground and second floor. (continued on LIC 809-C) (continued from LIC 809) BATHROOMS: The facility has two (2) bathrooms. One (1) is designated for staff use only. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured at 116.8°F COMMON AREAS: These included the living room and dining room areas. The living room has a couch, chair, table, and television. There is a shaded area with furniture in the backyard for residents' use. The dining room has a table large enough to seat six (6) residents. LAUNDRY ROOM: The laundry area is located adjacent to the dining area. It was observed to be locked during visit. GARAGE is attached to the house but has no access from the inside, it is also being used as emergency food, PPE, tools, frozen food and other miscellaneous storage. All cleaning agents and laundry detergents are kept in the laundry room. MEDICATIONS: Medications will be kept locked in a cabinet in the kitchen. Complete First aid kit is located by the cabinet by the bedroom hallway. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional. The swimming pool is appropriately fenced and observed to be locked during visit. Component III orientation was conducted with the Administrator and Licensee representative. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready to be licensed. CAB will be advised and a copy of this report provided Exit interview conducted. Copy of this report issued.