Pre-licensing visit·November 10, 2025

Licensing Program Analyst (LPA) Mariana Agban conducted a Pre-Licensing Inspection with facility Administrator/ Licensee Susanna Gasparyan and Staff Armen Sahredyan. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on May 27, 2025. A fire clearance was approved on July 29, 2025, for a maximum capacity of five (5) non-ambulatory residents, one(1) Bedridden resident. Hospice waiver has been requested for six (6) residents, which is pending approval of the Manager. A tour of the physical plant was initiated at 9:55 am, and the following was observed: KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, stove, and sink. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6) residents. COMMON AREAS: These included the living room and dining room, which were equipped with furniture, a television, and sofas. There is a fireplace with a screen and a glass slide. It is non-operational. No fireplace tools or fixtures present. The dining area has a dining table to accommodate six (6). There were no visible immediate hazards. LPA observed one fire extinguisher located in the dining /kitchen with a date of purchase of 07/15/25. The common areas were properly furnished. LPA tested the smoke alarms and carbon monoxide detectors, and they were functioning properly. BEDROOMS: There are five (5) bedrooms designated for residents' use. Four bedrooms are designated for private use , and 1 shared room. All bedrooms are furnished with beds, dressers, and required bedding and linen. The bedrooms have sufficient closet space. Bedrooms#2 and #6 are approved for one bedridden resident. The auditory alarms on all exit doors were on and functional at the time of the visit. LPA observed the office room where the Administrator is going to keep residents' medications locked and resident/staff files stored. (Continue 809C) BATHROOMS: The facility has two (2) main bathrooms in the main hallway. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 109.1 and 112.3 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. Laundry Area: The washer/dryer appears to be in good condition, and they were located in the main hallway between the residents' rooms. Laundry toxins were locked, and thus laundry detergents are inaccessible to residents. SURROUNDING GROUNDS: The driveway, passageways, and entrance to the home were clear of obstruction. There is a carport large enough to park two cars. 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. There is no swimming pool or bodies of water. The side gates were checked to ensure it was clear of obstruction. Staff and resident files: Staff and resident files will be kept and maintained in a locked cabinet in the office. In addition to the Pre-Licensing inspection, a Component III PowerPoint presentation was also held. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised, and a copy of this report provided.