Elite Care Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Zabel Chochian conducted a required annual visit at this facility. Upon arrival LPA met with staff and reason for the visit was explained. Administrator Irina Petrosyan was called and arrived to the facility. At approximately 2:15 p.m., a physical plant tour was conducted inside and outside with staff. The facility is one story. The facility has four (4) bedrooms which are designated for residents only. There are no staff rooms therefore, ‘awake night staff is required. There are two (2) bathrooms in the facility, and one (1) bathroom located outside in the laundry room is designated for staff. BEDROOMS: Resident bedrooms observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. RESTROOMS: There are three (3) restrooms of which one (1) is located in the hallway; resident room and laundry room for staff use only. Resident restrooms observed clean, sanitary, and in operating condition with grab bars and slip-resistant surfaces. Hot water temperatures were measured in restrooms and were between 110.6-115.9 degrees F, which is within the required range. COMMON AREAS: LPA observed living room and dining area to be clean and properly furnished. KITCHEN: LPA observed the kitchen/dining area. Knives are stored in a locked kitchen drawer. Kitchen appliances observed in operable condition; the facility has a sufficient supply of two-day perishable and seven-day non-perishable food. Fire extinguisher observed fully charged with receipt purchased on 4/30/2026. Smoke and carbon monoxide detectors were tested and functioned properly. Night lights were present in the hallways and passages. All exits have functioning auditory devices. LPA observed required postings throughout the common spaces. LAUNDRY/STORAGE ROOM: Washer, dryer, and laundry supplies were observed inside the locked laundry/storage room. OUTDOOR SPACE/GARAGE: LPA observed the front patio which has a covered area for resident use. Passageways were free and clear from obstruction. (Continue to LIC809c). There is a locked and gated pool, inaccessible to residents. The detached locked garage contains additional supplies. RECORD REVIEW: Beginning at 02:30PM, LPA reviewed two (2) resident files and three (3) personnel files for documents including but not limited to: medical records, care plans, resident Admission Agreement, TB test, health screening, staff training and fingerprint clearance. All resident and personnel files were in order. LPA requested Administrator to send copy of valid liability insurance, and LIC 500. MEDICATION REVIEW: Medications are centrally stored in a locked cabinet in the kitchen. LPA and Administrator reviewed both residents medications. All medications were labeled, stored, and locked inaccessible to residents. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today's visit, LPA reviewed the facility's infection control policy as well as the emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency drills will be conducted quarterly as required. No deficiencies cited at this time. Exit interview conducted and copy of the report was issued.the state’s words, verbatim · CDSS document, May 13, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo conducted an unannounced required annual visit today. Upon arrival, the facility appeared empty. The LPA called Administrator several times. At 9:49am, the LPA received a telephone call from the Administrator stating the house is vacant and currently no one resides at the property. The Administrator stated they are working on getting residents into the facility and advised the LPA that they were unavailable to come to the facility at this time, but would be available later in the afternoon. The LPA was unable to conduct annual inspection today and will return at a later date to complete inspection. Exit interview conducted. Report was emailed to the Administrator for a hard copy signature.the state’s words, verbatim · CDSS document, May 5, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Emily Peraldi conducted a pre-licensing visit to the above noted facility. At 1:09 p.m., the LPA met with applicant, Irina Petrosyan. This is a new facility. A dementia program was included in the plan of operation. A Hospice Waiver for six (6) has been approved. At 1:17 p.m., a physical plant tour was conducted inside and out. An approved fire clearance was received, clearing them for six (6) non-ambulatory residents, of which one (1) may be bedridden. The facility is one story. The facility has four (4) resident bedrooms. Resident bedroom #4 has a direct exit to the outside. Bedridden resident is allowed in resident bedroom #4. All resident rooms are set up with beds, nightstands, lamps, chairs, chest of drawers and closet space. The beds are furnished with box springs, comfortable mattress and clean linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket (if needed). Lighting in the rooms appeared adequate. The bedrooms were large enough to allow for easy passage between the beds and furniture with a wheelchair or walker. In addition, no bedroom was used as a passageway to another room, bath or toilet. There are no staff rooms – ‘awake night staff only’ - is required. All rooms were free of odors. All window screens were clean and maintained in good repair. There are three (3) bathrooms in the facility, and the bathroom located in the laundry room is designated for staff. The resident bathrooms have a shower with non-skid materials/ mats. The toilet and shower have grab bars. The hot water temperature was tested in the bathroom and the kitchen and was found to be within the range of 105*F and 120*F. Resident and staff records will be stored in the office area inside locked filing cabinets. Medications are centrally stored in locked kitchen cabinet. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. Continued on LIC 809-C. Kitchen knives are stored in a locked kitchen drawer. The supply of dishes, utensils, pots, pans and drinkware is adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of nonperishable food is adequate. There are no pesticides (poisons) or toxins stored in any food storage area or preparation area. Appliances in the kitchen were clean and all appeared functional. Cleaning supplies were locked away under the kitchen sink. Laundry and house cleaning supplies are stored inside the locked laundry room. No flies or other vermin were observed. The common areas were appropriately furnished, and the lighting was adequate. There is a television and other entertainment equipment, games and/or activity supplies in the living room. There was sufficient space to accommodate both indoor and outdoor activities. Night lights were maintained in hallways and passageways to nonprivate bathrooms. All ramps were secure and non-slippery and were positioned at the level where wheelchairs and walkers may enter and exit the facility safely. Alarms on all exterior doors were engaged at the time of visit and functional. In addition, the physical plant is consistent with the submitted facility sketch/floor plan. The facility had emergency lighting, which included but not limited to flashlights. The facility had emergency food and water supplies. The facility has a furnace, which is able to heat rooms that residents occupy to a minimum of 68 degrees Fahrenheit; and, they have central air conditioning and are able to cool rooms to a comfortable range, not to exceed 85 degrees Fahrenheit. The facility smoke alarm system is hard wired. At 1:30 p.m., the smoke detector and carbon monoxide detectors were tested and functioned properly. The facility has a central entry point for symptom screening and temperature checks for staff and visitors. There are hand sanitizers available throughout the facility. The fire extinguisher near the kitchen was fully charged and purchased on 01/11/2024. The supply of extra bed and bath linens is adequate. Personal hygiene items (shampoos, soaps) were adequate and are stored in the laundry room. There is a functioning telephone on the premises. The emergency exiting plans/sketch are posted throughout the facility. The emergency telephone numbers are posted near the entrance of the facility. Other required postings are also posted near the entrance of the facility. Continued on LIC 809-C. The exterior passageways were clean and clear of any obstructions. There is a covered patio area at the front of the house with tables and chairs where residents can sit. The property is gated. One side of the house is designated for an emergency exit. The garage is detached from the house and will remain inaccessible to residents. There are bodies of water on the premises at the present time. Located in the backyard is a swimming pool which is fenced and with an appropriate lock. Component III was conducted in conjunction with this pre-licensing visit. No corrections required. Exit interview conducted. A copy of the report was issued. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license.the state’s words, verbatim · CDSS document, May 3, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Irina Petrosyan Interview Method: Telephone interview On April 09, 2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restricted/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Apr 9, 2024