Routine inspection·October 5, 2023

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE tool. LPA met with Gohar Armani and explained the reason for the visit. The facility is licensed to served 6 residents, 60 years and over; of which 5 may be non-ambulatory and 1 bedridden. Facility consist of a living room, a dining room, a kitchen, 4 resident bedrooms, 2 bathrooms, a laundry area, a backyard, and a garage. LPA toured the facility with Gohar Armani and observed the following: Facility is in good repair indoor and outdoor. Living room and dining room have sufficient sitting furniture. Laundry area is open and cleaning supplies were observed next to the dryer. Kitchen area is clean. Cleaning supplies were observed under the sink unlock at the time of the visit. Sufficient food supplies were observed for at least 2 days of perishables and 7 days of non-perishables. Each resident bedroom (4) was observed with sufficient lighting, furniture, and bedding supplies. Bathrooms (2) each is clean, and in working condition, grab bars/skid mats were observed. Water temperature was tested between 114.3 - 117.5 degrees F., which is within the required 105-120 degrees F. Outdoor area is clean and has a covered shaded sitting area. Garage has additional food/cleaning supplies stored. Medication is stored in lock cabinet. Carbon/Smoke detectors were tested and in working condition. Fire extinguisher was observed on the laundry and garage. LPA reviewed Emergency Disaster Plan and last fire drill was conducted on 12/23/22. A copy of liability insurance was requested. LPA reviewed medication, and files for 5 residents. 4 staff files were reviewed, file for staff #5 was not at the facility at the time of visit. Staff #4(S4) does not have a criminal clearance, began working on 9/25/23. Staff #2 and #3 (S2-S3) are not associated to the facility, S2 began working on 2/9/23 and S3 began working on 10/1/22. 4 staff training logs were observed for August and September 2023, no duration of training on the sheets. Administrator certificate was observed for Nvard Gevorkian exp date 12/23/24. Deficiencies are noted on LIC 809D per Title 22 Regulations. Immediate Civil Penalties have been assess. Exit interview was conducted with Nvard Gevorkian and a copy of report, LIC 809D, and appeal rights were provided.