Pre-licensing visit·December 23, 2025

Licensing Program Analyst (LPA) Michael Cava conducted a Pre-Licensing Inspection with the applicant/administrator, Zaruhi Atayan. An Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on November 3, 2025. A fire clearance was approved on December 1, 2025 for five (5) non-ambulatory residents and one (1) bedridden resident, for a total capacity of six. Per STD 850, bedroom #5 has clearance for bedridden. The applicant is also requesting a hospice waiver to retain six (6) residents. The smoke alarms and carbon monoxide detector are dual, hard wired and inter-connected. The facility has one new fire extinguisher that was purchased on November 21, 2025. Complete first aid and manual is located in the kitchen. Prior to the Pre-Licensing inspection, a Component III power point presentation was held between 9:15am to 10:15am. A tour of the physical plant was initiated at approximately 10:20am and the following was observed: KITCHEN: The kitchen area is equipped with a refrigerator, stove/oven, microwave and sink. At this time, perishable food items not required as there are zero (0) residents. Applicant advised to purchase perishable food items once facility is licensed and operational. There is an adequate supply of nonperishable food and dining ware to accommodate a maximum capacity of six (6). Knives will be locked in a kitchen drawer. BEDROOMS: There are five (5) bedrooms designated for resident use. Bedroom #1, #2, #3 and #4 are private. Bedroom #5 is shared. The applicant furnished the resident bedrooms with beds, night stand, chairs, dresser, bedding and linen. The bedrooms have sufficient lighting and closet space. BATHROOMS: The facility has three (3) bathrooms. Bedroom #4 has it's own full bathroom. The other two bathrooms are located in the hallway, across from each other, by bedrooms #1, #2 and #3. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured at 114 and 116 degrees. COMMON AREAS: These included the living room and dining room area. The living room is equipped with sufficient seating, couches, table and television. The dining room table can seat up to six (6). There is no fireplace. Floors are new and in good repair. All passageways and hallways are clear of obstruction. LAUNDRY ROOM: Washer/Dryer is stationed in the garage. MEDICATIONS: Two cabinets in the kitchen will be designated to store medications. Medication cabinets is observed to have magnetic locks. STAFF/RESIDENT RECORDS: Staff and resident records will be stored in a filing cabinet, located in the kitchen. GARAGE: The garage is attached to the home. Entry way from the home is through the kitchen. Entry way is locked, with key from the inside of the home. Garage will be used as laundry area and storage space for cleaning supplies, emergency water and food. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alert. The backyard of the facility has a patio and backyard furniture to accommodate the six (6) residents. The facility backyard has sufficient yard space to hold outdoor activities. There is no swimming pool or any other bodies of water. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment is compliant during the day of the inspection and ready for licensure. CAB will be advised and a copy of this report provided.