Pre-licensing visit·September 4, 2025

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an announced Pre-Licensing inspection visit. LPA met with Administrator Pauline Halladjian and Kevork Halladjian explained the reason for the visit. The facility has an approved fire clearance to be licensed to serve six (6) residents; five (5) non-ambulatory and one (1) bedridden. Bedroom #3 with direct exiting to the exterior shall house the one (1) bedridden resident. All other rooms will be non-ambulatory. LPA and Applicant toured the physical plant interior and exterior. The Pre-Licensing Inspection CARE Tool was used. The following was observed/inspected: The facility is a two-story home located in a residential neighborhood of Glendora. The home consists of 3 bedrooms, 2 bathrooms, and hal-bath for staff located near dining area, kitchen, two (2) living rooms, dining area, laundry area, backyard with a pool and an attached garage. The second floor is inaccessible to residents and will be utilized as an office and staff area. Smoke and carbon monoxide combination detectors observed, tested and are operable. The fire extinguisher located in the dining are was observed and charged. Appliances such as a microwave, refrigerator and stove were observed to be clean and operating properly. Sharps were observed secured under the kitchen sink, inaccessible to residents. continued on LIC 809C continued from LIC809, page 2 Centrally stored medication will be located in a locked cabinet located in the kitchen. Staff and client files will be maintained locked in a cabinet located in a hallway closet. Dining area was observed clean with sufficient seating for six (6) residents. Fireplace in dining area is not operational. Living rooms were observed free of obstructions with sufficient seating and space to promote and facilitate the program of activities. Fireplace in the living room had a covered screen. All cleaning solutions and disinfectants were observed locked under the kitchen sink, laundry area and garage. Grab bars and non-skid mats were observed in the hallway bathroom. The shower in the private bathroom located in a resident bedroom will not be utilized. The water temperature was tested in both bathrooms and measured at 116 and 112.6 degrees F, within the required 105-120 degrees F. Residents’ bedrooms have all required furniture which include, for each resident, a bed equipped with good springs, a clean and comfortable mattress, available pillow(s) and lightweight warm bedding, fillings and covers for mattresses and pillows were flame retardant, a chair, nightstand, a lamp, or lights sufficient for reading, and a chest of drawers. Bed linens were clean and in good repair. There was closet space for clothing and other belongings. Extra clean linens were observed in the hallway storage cabinet. No bedroom of a resident shall be used as a passageway to bathroom or outdoors. Doors, exits, hallways, and passageways were clear and free of obstruction. The front and back yards were observed to be clean and free of debris. LPA observed the backyard to have a covered seating area with sufficient seating for six (6) residents and a pool which was made inaccessible through fencing. LPA observed a locked pool gate that opens away from pool and self-latches. LPA observed the surrounding area did not have any objects that can be used to climb over the fence. continued on LIC 809 page 3 Backyard contained a pool house for private use, locked and inaccessible to residents. Per facility sketch (additional area 2) contains separate, private living quarters, possibly for staff. LPA provided applicant with the following information: • PIN 24-03-ASC, Subject: Safety Requirements for Facilities with Pools and Other Bodies of Water • LIC 311F, Records to be Maintained at the Facility- Residential Care Facility for the Elderly Comp III was completed during today’s visit with applicant Pauline Halladjian. The Pre-licensing is complete, and the facility has no deficiencies. An exit interview was conducted, and a copy of this report has been provided to applicant. Accordingly, 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.