Pre-licensing visit·November 13, 2025

Licensing Program Analyst (LPA) Jose Tan conducted a Pre-Licensing Inspection with the applicant representative Anush Arzumanyan. The applicant is "LA Board and Care". A fire clearance was approved on 07/07/25 for six (6) non-ambulatory residents, two (2) of which may be bedridden on either Room #1, #2 or #3. The applicant has an approved hospice waiver for six (6) residents. The facility has a total of four (4) bedrooms and two (2) bathrooms. One of the room is designated as an office and the other one is designated for staff use only. One (1) bathroom is also designated for staff use. A tour of the physical plant was initiated at approximately 10:00 AM and the following was observed: KITCHEN: The facility has a Kitchen that is equipped with a refrigerator, microwave, stove, dishwasher and sink. Knives will be kept locked in a kitchen drawer with locking mechanism. Cleaning supplies and other toxins will be stored in the cabinet in the bedroom hallway which was locked during visit. BEDROOMS: There are four (4) bedrooms designated for client's use. The applicant furnished the resident bedrooms with beds, night stand, chairs, dressers, bedding and linen. The bedrooms have sufficient lighting and storage. BATHROOMS: The facility has two (2) shared bathrooms for clients' use. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water temperature was measured at a range of 111.7°F to 113.0°F. (continued on LIC 809-C) LAUNDRY ROOM: The laundry room is located in the hallway. Laundry detergents and other cleaning agents were locked in a cabinet along the bedroom hallway. The laundry room was observed to be locked during visit. COMMON AREAS: These included the living room and the dining area. Living room was furnished with chairs and side tables. The living room area was furnished with a television, a sofa to sit the capacity of the facility. There were no visible immediate hazards. There is a working telephone line and internet accessible to residents. Dual smoke/carbon monoxide alarms were tested and observed to be operable. Fire extinguisher was last bought on 09/24/25 located in the living room area. The facility is equipped with sprinkler system and closed circuit television system in the common areas. MEDICATIONS: The medication cabinet is located in the bedroom hallway and has has a locking mechanism. A complete first aid kit is located inside the medication cabinet. Staff/Resident Records: Staff and resident records will be kept in the same medication cabinet SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The backyard of the facility has a covered patio and backyard furniture to accommodate the residents. There is no garage at this facility only open car port at the front. There is another storage at the back end of the lot but observed to be locked and inaccessible to residents. There is no body of water in the facility. Component III was waived with the approval of LPM Troy Agard. Licensee representative has been an RCFE Administrator with her other RCFE facility for about three (3) years. This report will be sent to Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when the license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted. Copy of this report issued.