Pre-licensing visit·February 6, 2025

Licensing Program Analyst (LPA) Galarza made an announced visit and met with Licensees Ara Postaldjian and Sharon Giragosian to conduct a Pre-Licensing evaluation. An application was submitted to Community Care Licensing Department (CCLD) on for an initial application of a Residential Care Facilities for the Elderly (RCFE) to serve adults ages 60 and over. A Dementia waiver and a hospice waiver for six (6) is in place. The requested capacity is for five (5) non-ambulatory and one (1) bedridden in room #1. Structure: Facility is a single-story home located in a residential area consisting of four (4) bedrooms [2 private and 2 shared], three (3) bathrooms, kitchen, dining room, living room, laundry area in the backyard shed area, detached garage with 2 parking spaces, and backyard outdoor patio area. Front yard is landscaped with grass. Bedroom Clients: Two (2) bedrooms are designated as private bedroom and two (2) will be shared. Bedrooms are equipped with one bed, night-stand, chair, lamp, and overhead lighting. Bathrooms: Three (3) full bathrooms are equipped with working toilets, wash basins, bathtub/ walk-in shower. Linens & Hygiene Supplies: All beds had the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Adequate supply of linens is stored in bedroom closets. Emergency Phone Numbers, Exit Plan: Emergency numbers are posted and readily available for review. Two (2) fully charged fire extinguishers were observed. Facility has a land line telephone. Food Service: Dishes, cups, and flatware are stored in the kitchen cupboards, inspected and in good repair. Knives, cutlery, and other sharp kitchen utensils were observed locked and inaccessible. Adequate food supply is stored in the kitchen and consists of the following: 2-day perishables, and 7-day non-perishables. Emergency water supply was observed. Smoke Detectors: There are electrical & inter-connected smoke detectors located in all bedrooms, common areas, and hallways. Appliances: Refrigerator , oven, microwave, dishwasher and washer/dryer are in new condition. The residence is equipped with central heating and air conditioning. Toxins: Cleaning supplies, and toxins are locked only accessible to staff. ***Narrative continues next page.**** Water Temperature: Hot water was tested in all bathrooms, and kitchen sink. Water temperature was not within normal limits 105 degrees Fahrenheit (40.5 degrees C) and not more than 120 degrees Fahrenheit (48.8 degrees C). Medication, First-Aid Kit & Book: Designated centrally stored medications cabinet, and the first-aid kit has been inspected which has at least the following: tweezers, scissors, antiseptic, bandages, gauze, thermometer; including a current First Aid manual. Clients & Staff Files: Designated area for files will be in the kitchen. Pools/Jacuzzi/Body of Water & Pets : No bodies of water are in the premises. Fire Clearance : Fire clearance was approved on 1/30/2025 for 5 non-ambulatory, of which 1 may be bedridden in room #1. Component III: Component III was waived. Applicant is presently a Licensee of other RCFE's. No items of correction were observed. An exit interview was conducted with Licensees. A copy of the report was issued. LPA will submit a copy of this facility evaluation report to the Central Applications Bureau (CAB) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAB Analyst assigned to their application.