Affordable Boarding Care

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Tihesha Smith made a case management visit in conjunction with complaint # 31-AS-20251020124906. LPA Smith observed that the front door was equipped with a deadbolt, which requires a key to exit the facility. LPA discussed the concern with the administrator and informed her that the deadbolt must be removed today. LPA advised that a daily civil penalty will be assessed if the lock is not removed. The administrator stated she will remove the deadbolt and will send photo verification. Deficieny cited on 809D Exit interview conducted/copy of report issued.the state’s words, verbatim · CDSS document, Aug 23, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87203 · Plan of correction due date: Aug 24, 2026

All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement was not met: Based on the presence of a deabolt lock that requires a key to exit which poses a serious risks to residents in carethe state’s words, verbatim · CDSS document, Aug 23, 2026

Plan of correction: Administrator must move lock immediately and provide photos.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jose Tan conducted an unannounced visit and was greeted by the staff Samantha Baltazar who called the Administrator. Administrator Sona Galstyan arrived about an hour later. LPA explained the reason for the visit. The facility is fire cleared for six (6) non-ambulatory residents, five (5) of which may be bedridden in Rooms 2 to 4. Hospice waiver for six (6) residents. At 9:21 AM, LPA conducted the physical plant tour with the staff and observed the following: The facility is a single storey with six ()6 bedrooms and four (4) bathrooms. Two (2) bedrooms and one (1) bathroom is designated for staff use. Dual smoke and carbon monoxide alarms were tested and observed to be operable. The facility is equipped with sprinkler system. Common Areas – The family room, dining room, and kitchen are combined. The family room was furnished with comfortable seating and a television. The dining room contained a dining room table and chairs. Fire extinguishers were located near the kitchen and the main door upon entry and last inspected on 11/14/25. Medications: LPA observed the resident medications and first aid kit were safely locked in a kitchen cabinet. Kitchen: LPA observed a two day supply of perishable food and a seven day supply of non-perishable food items. Dishwashing liquid and other cleaning agents were observed locked underneath the kitchen sink. Laundry Room is located adjacent to the kitchen and was observed to be locked during visit. Laundry detergent and other toxins were locked in the garage. (continued on LIC 809-C) (continued from LIC 809) Garage - The garage was attached to the house and was observed to be locked during visit. The garage is also being used as frozen and emergency food, PPE, cleaning agents, laundry detergents and other toxins and old equipment storage. Resident Rooms: There are four resident rooms which were furnished with a bed, linens, night stand, lamp and chair. The rooms were properly furnished and observed to be neat and clean. Staff Rooms are furnished, neat and organized. No medications were observed at the staff room. Bathrooms: There are three bathrooms in the facility. The bathrooms contained hand soap, paper towels, grab bars, and slip resistant mats. LPA observed the clean linens were located in a cabinet within the staff bathroom. Water Temperature: was tested and measured at a range of 115.2°F to 115.8°F. Surrounding Grounds: There were no visible hazards, and passageways were free from obstruction. There is a shaded area with comfortable seating in backyard. Client records: Client records are reviewed. Client records appeared to be complete and updated. Staff records: LPA conducted a complete file review of staff record. Staff records appeared to be complete and updated. Disaster drill was last conducted on 01/05/26 . Required posting are observed to be complete and current and displayed properly at the facility. Exit interview conducted. Copy of this report issuedthe state’s words, verbatim · CDSS document, Mar 7, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the caregiver. The caregiver confirmed there are two residents. The Administrator Sona Galstyan arrived at 2:25 pm. LPA Spaeth stated the purpose of the visit was to tour the facility and review residents' files. LPA reviewed the residents' files at 2:30 pm until 2:50 pm. LPA Spaeth and the Administrator toured the facility at 3:30 pm until 3:35 pm. LPA observed the facility was neat and clean. There are no deficiencies to report at this time. Exit interview conducted and a copy of the report was given.the state’s words, verbatim · CDSS document, Feb 27, 2025

Type of visit: Prelicensing

On 01/08/2025 Licensing Program Analyst (LPA) Melissa Spaeth conducted an announced pre-licensing visit to this facility and met with the Applicant, Sona Galstyan. This is a new application. A fire clearance dated 08/20/2024 was received for one (1) ambulatory resident and five(5) bedridden residents for a total capacity of six (6) residents. Bedroom one (1) is designated to house one (1) ambulatory resident, bedroom two (2) to house two (2) bedridden residents, bedroom three (3) to house two (2) bedridden clients, and bedroom four (4) to house one (1) bedridden client. The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6. Component III was conducted with the applicant from 9:45 am until 11:30 am. Today’s site visit consisted of LPA touring the physical plant inside and outside from 11:30 am until 12:00 pm. LPA Spaeth observed the following: Living Room/Office – the living room contained comfortable seating and a television. The room is also the facility office which contains two drawer cabinets. The resident and staff files will be locked within one of the cabinets. Kitchen/Dining/Family Room - The knives were locked in a kitchen drawer and the medications will be locked in a kitchen cabinet. The washer/dryer are located in a closet within the kitchen. A fire extinguisher is located in the kitchen. The dining room section contained a dining room table and chairs. The family room contained comfortable seating, games, and a television. Continued on 809-C Backyard - The backyard contained a designated area for outdoor activities. The side gate leading from the backyard to the front yard was not locked. LPA Spaeth observed a gazebo arrived during the visit. Water Temperature - The water temperature was tested at 11:25 am and was 112.0 degrees F. Bathrooms- There are four bathrooms which contained hand soap, slip resistant mats, paper towels, grab bars, and a trash can. Bedrooms - There are four bedrooms which contained bed, linens, night stand, chest of drawers, a chair, and a closet. Hallway Closet - The hallway closet contained linens. Laundry Closet – A washer and dryer are located in the closet within the kitchen area. Garage – the garage was locked and contained canned good items, cleaning solutions, hygiene items, and laundry detergent. The smoke/carbon monoxide detectors were tested at 12:00 pm and were operable. The facility was clean and appears to be in good repair. This report will be forwarded to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved.the state’s words, verbatim · CDSS document, Jan 8, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Sona Galstyan (Board Member/Administrator) Interview Method: Virtual interview via Microsoft Teams On December 17, 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 that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. 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. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Dec 17, 2024