Pre-licensing visit·March 23, 2026

On 03/23/26, at 9:10am, Licensing Program Analyst Gina Saucedo conducted an announced Pre-licensing visit. LPA met with Sergey Azaryan, Administrator. An application was submitted to Community Care Licensing Division-CCLD on 09/2025, Initial license for a Residential Care Facility for the Elderly (RCFE), 60 years and older. The requested capacity is for six (6)- five (5) non-ambulatory and one (1) bedridden and the fire clearance was approved on 10/02/2025. Structure : This is a one-story single-facility with six (6) bedrooms and three (3) bathrooms and a backyard. There is also a JADU-Junior Accessory Dwelling Unit with a separate address. Entrance : There is only one (1) entrance being utilized. Required postings such as: YES are posted against the wall of the facility on your right hand side, Theft and Loss and Personal Rights. Toxins, cleaning solutions, and laundry detergents will be kept locked in a cabinet area inaccessible to residents towards the back of the facility. Living/Dining area : The living room is neat, clean, and organized with sufficient seating for both residents and staff. Both areas are properly furnished and in good repair. The facility maintains a comfortable temperature of seventy-two (72) 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 by the kitchen area. Kitchen : Sufficient supplies of dishes, cups, and silverware located within the kitchen cabinets and drawers. Sharps are stored on the right side of the kitchen locked and inaccessible to the residents. Kitchen appliances are working and are in good repair. Emergency : Fire extinguisher located in the kitchen on the left side and dated 08/2025. Medications : The medication is currently kept in a white cabinet locked and inaccessible to the current residents. First-aid kit will also be kept in this area. 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. Staff room : there is no designated staff room in the facility at this time. Water Temperature : The water temperature was measured in the bathrooms between 115.5 and 115.1 Fahrenheit and is within regulations. There are cameras in common areas and the facility has a signal system. LIC809C-continued Smoke detectors : Dual interconnected smoke detectors and carbon monoxide observed to be working properly and were tested. Garage : There is a no garage. Outside: There is a shaded area for residents. 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. Be advised, this was a unlicensed facility and are now approved for a license. There is currently the same two (2) residents present at the facility. Sergey Azaryan, Administrator is currently the staff providing care and supervision along with staff-Samarakul Abdyraimova. Exit interview conducted and copy of this report issued to the administrator.