Routine inspection·June 18, 2025

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility unannounced to conduct a required annual visit. LPA initially met with facility staff. Co-Administrator Vana Barberis and Licensee Cilva Toume arrived to assist LPA with visit. Beginning at 11AM, the LPA, along with staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: Fire extinguisher is fully charged and purchased on 05/23/2024. Smoke and Carbon Monoxide detectors were tested at approximately 03:16PM. All were functional at the time of the visit. BEDROOMS : There are 7(eight) total bedrooms in the facility; 6 (six) bedrooms are designated for resident use, 1 (one) staff room. The staff room is kept locked and the storage room did not contain any hazardous items. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. BATHROOMS : There are 3 (three) total bathrooms in the facility. 1 (one) is used for staff, 1 (one) is a private resident bathroom, and 1 (one) is a hallway bathroom designated for shared resident use. Resident restrooms were observed to be equipped with nonskid surfaces and contain nonskid mats. Grab bars were observed in the bathrooms. The water temperature was measured in shared resident bathroom and measured in compliance with regulation (110.4*F). COMMON AREAS : This includes the living room and dining room areas. LPA observed common area to be clean and properly furnished at the time of the visit. LPA observed a door stop installed on the fire door in the common area leading to the resident bedrooms. Fire clearance indicates "door stops are prohibited." Medications are stored in a locked hallway cabinet. (Continue to LIC809c). KITCHEN : The LPA observed the kitchen to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of seven (7) days non-perishable and two (2) days perishable food. Knives are stored in a locked box in the kitchen. GARAGE : Garage was observed locked and contained laundry area, locked chemical storage, extra food, supplies, and emergency food and water. OUTDOOR SPACE: The backyard has a shaded patio area with patio furniture including a table and chairs for resident use. All passageways were observed to be clear. RECORD REVIEW: LPA reviewed 6 (six) resident files during today's visit. Staff files and additional resident files will be reviewed during annual continuation visit. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster plan was observed to be complete and updated annually, as required. INTERVIEWS: During today's visit, LPA interviewed 3 (three) residents and 1 (one) staff. MEDICATION REVIEW: Will be observed during annual continuation visit. Due to time constraints annual inspection will be continued to another day. Exit interview conducted. A copy of the report and appeal rights were provided.