A Dream Villa

Type of visit: Required - 1 Year

On 06/03/2025 at 10:37AM, Licensing Program Analyst (LPA) Gina Saucedo conducted an unannounced, Annual Inspection and met with caregiver, Karine Kesabyan and the administrator Azniv Ter-Arsenyan was called and arrived about twenty (20) minutes later. The physical plant was toured inside and out at 11:15am. Living/Dining Room Area: LPA Saucedo observed the living room furniture to be clean and in good repair. The facility maintains a comfortable temperature at 74 degrees Fahrenheit. There is a fire extinguisher at the entrance of the facility on your left-hand side dated 05/2026. The telephone line is located in the living room. Bedrooms: There are six (6) bedrooms for single, occupancy. All resident rooms are numbered. One (1) room is currently vacant. LPA observed rooms to have bedding sheets, pillowcase, blankets, nightstands, televisions, and sufficient lighting for each of the residents sharing the room. Next to bedroom number one (1) there is a closet that is filled with extra linen. There is also a staff office only accessible to staff. Bathrooms: There are two (2) bathrooms that were toured and checked to make sure bathrooms were clean and in good repair. The hot water temperature measured within regulations of 113 degrees Fahrenheit and 115. The showers have non-slip bathmats and grab bars. Medications were kept in a locked cabinet in the hallway. All medications were properly labeled and inaccessible to residents. LIC 809C-continued Kitchen Area: LPA inspected the kitchen area. The refrigerator was clean and in good operation. Knives and sharp objects are kept locked in a cabinet located in the kitchen on your right-hand side and inaccessible to the residents. LPA observed sufficient supply of seven (7) day non-perishable and perishable foods in the cabinet. There is a complete first aid kit located on the kitchen counter. There are chemicals at the bottom of the sink that are locked and inaccessible to the residents. Outside: LPA toured the outside area. LPA observed a covered shaded area for residents and appropriate outdoor furniture. The facility has no body of water on the premises. There is one (1) gate that is locked leading to the outside area towards the street. There are also ramps provided for wheelchair residents. There is one (1) shed that LPA was able to observe and there is a bird cage that is locked and inaccessible to the residents outside of the facility. The carbon monoxide is interconnected with the smoke detector was tested and it was operable. There is also a signal system for the above facility. Garage: The garage is attached to the facility there is an access door from the laundry area. It is used for additional storage of food, chemicals, and laundry area. The laundry area has one (1) washer and one (1) dryer. There are chemicals and extra hygiene on the top shelves inaccessible to the residents. Administration: There was Covid 19 signs on the wall, hygiene sanitation signs, Ombudsman, Theft and Loss Policies, Emergency and Disaster Plan,Rights of Resident Council, Personal Rights and YES sign, surety bond was viewed, and it is up to date. It expires on 02/06/26. Five (5) resident files were reviewed and two (2) staff. An exit interview was conducted, no citation(s) were issued, and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Jun 3, 2025

Type of visit: Required - 1 Year

On 05/22/2024 at 08:55 AM, Licensing Program Analyst (LPA) Gina Saucedo conducted an unannounced, Annual Inspection and met with caregiver, Gayane Grigoryanya and the administrator Azniv Ter-Arsenyan was called and arrived about fifteen (15) minutes later. The physical plant was toured inside and out at 9:20 am. Living/Dining Room Area: LPA Saucedo observed the living room furniture to be clean and in good repair. The facility maintains a comfortable temperature at 70 degrees Fahrenheit. There is a fire extinguisher at the entrance of the facility on your left-hand side dated 06/2023. The telephone line located in the living room. Bedrooms: All six (6) bedrooms are single, occupied. All resident rooms are numbered. LPA observed rooms to have bedding sheets, pillowcase, blankets, nightstands, televisions, and sufficient lighting for each of the residents sharing the room. Next to bedroom number one (1) there is a closet that is filled with extra linen. There is also a staff office only accessible to staff. Bathrooms: There are two (2) bathrooms that were toured and checked to make sure bathrooms were clean and in good repair. The hot water temperature measured within regulations of 115 degrees Fahrenheit and 118. The showers have non-slip bathmats and grab bars. Medications were kept in a locked cabinet in the hallway. All medications were properly labeled and inaccessible to residents. Kitchen Area: LPA inspected the kitchen area. The refrigerator was clean and in good operation. Knives and sharp objects were kept centrally stored and locked in a cabinet located in the kitchen on your right-hand side. LPA observed sufficient supply of seven (7) day non-perishable and perishable foods in the cabinet. There is a complete first aid kit located in the kitchen. LIC 809C-continued Outside: LPA toured the outside area. LPA observed a covered shaded area for residents and appropriate outdoor furniture. The facility has no body of water on the premises. There is one gate that is locked leading to the outside area towards the street. There are also ramps provided for wheelchair residents. There is one (1) shed that LPA was able to observe and there is a bird cage that is locked and inaccessible to the residents. The carbon monoxide is interconnected with the smoke detector was tested and it was operable. There is also a signal system for the above facility. Garage: The garage is attached to the facility there is an access door from the laundry area. It is used for additional storage of food, chemicals, and laundry area. The laundry area has one (1) washer and one (1) dryer. There are chemicals and extra hygiene on the top shelves inaccessible to the residents. Administration: The mitigation and the Infection control were reviewed and there was Covid 19 signs on the wall, hygiene sanitation signs, Ombudsman, Theft and Loss Policies, Emergency and Disaster Plan,Rights of Resident Council, Personal Rights and YES sign, surety bond was viewed, and it is up to date. The carbon monoxide is interconnected with the smoke detector was tested and it was operable. An exit interview was conducted, no citations were issued, and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, May 22, 2024

Type of visit: Required - 1 Year

On 11/27/2023 at 09:00 AM, Licensing Program Analyst (LPA) Christopher Alemoh conducted an unannounced Required – Annual Continuation Inspection and met with Staff Gayane Grigoryanya and Administrator Azniv Ter-Arsenyan. Six (6) residents and Two (2) staff were present during this inspection. Facility has been approved for a capacity for six (6) residents of the age of 60 age Facility has been approved for a capacity for six (6) residents in which five (5) may be non-ambulatory and one (1) bedridden. Hospice waiver has been approved for six (6) residents. The Annual Licensing Fees are current. The home consists of 1 floor level with: six (6) bedrooms and two (2) bathrooms kitchen, dining room, and laundry room and staff room. At 09:15AM the administrator accompanied LPA inside and outside the facility. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. The facility has six (6) bedrooms in which all will be single use. Bedroom number one (1) will be designated for bedridden residents. All the other rooms have been approved for non-ambulatory residents. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, hot water temperature properly measured between 110.9-111F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. Facility Temp observed at 69 degrees Fahrenheit. LPA toured the kitchen area and observed a two day supply of perishable and a seven day supply of non-perishable food. Knives and toxins were kept in locked storage cabinet next to the stove. First Aid kit/manual near the oven. One fire extinguisher, last serviced June 6th, 2023, was observed on a wall next to the front entrance. LPA tested all carbon monoxide detectors and smoke detectors located in the kitchen area. Both devices were functional. LPA observed that all bedrooms and hallways are equipped with a carbon monoxide and smoke detector. Kitchen Temp measured at 112 degrees Fahrenheit. LPA reviewed Medication and Medication Records for Six (6) residents all medication files had the proper documentation. At 09:55AM Six (6) staff records were reviewed, 6 out of 6 staff records had current first aid certificates and had required criminal record clearances or criminal record exemptions. At 11:10AM Six (6) resident records were reviewed and, 6 out of 6 client records had Admission Agreements, Medical Assessments, Pre-appraisals (or Reappraisals) and/or Needs & Services Plans. Exit Interview Conducted / Appeal Rights Discussed / A Copy of the Report Issued.the state’s words, verbatim · CDSS document, Nov 27, 2023