All About You

Type of visit: Prelicensing

At 9:45 AM, Licensing Program Analyst (LPA), Huma Rahimi conducted an announced Pre-Licensing visit to the above facility and met with Marine Zakaryan, Licensee, and explained the reason for the visit. At the time of this visit LPA did not observe any residents present in the facility. Fire Clearance dated 06/18/2025 and received for five (5) Non-ambulatory residents and one (1) bedridden resident in bedroom #3. The purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22, Division 6. The facility is a single-story building. Today's site visit consisted of LPA touring the physical plant inside and outside and observed the following: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, oven, and a sink. Stove was observed in a good working condition. At 9:55 AM, LPA observed adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6) residents. All knives and sharps are observed to be locked in a locked box in the kitchen. LPA observed a Fire Extinguisher and was last purchased on 03/11/2025. It was observed handing on the wall in the by the kitchen area. MEDICATION ROOM: The centrally stored medication will be kept in the in the locked cabinet in the laundry/office area of the facility. Facility staff and residents files will also be kept in the laundry/office area in a locked cabinet. BEDROOMS: There are total of four (4) bedrooms and all bedrooms are only designated for residents use. Bedroom #1 and bedroom #2 are shared. Bedroom #3 and bedroom #4 are private. LPA observed that all bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. The facility will have an awake staff Continue on LIC 809C BATHROOMS: There are two (2) bathrooms at the facility. One of the bathrooms is located in room #2 and another bathroom is in the hallway. LPA observed both bathrooms to be clean and in a good repair. Properly supplied with toilet papers, soap and paper towels. The water temperature was noted at 118.9°F. LAUNDRY ROOM: The laundry/office is across from the kitchen and LPA observed to be locked. All cleaning supplies and laundry detergents will be kept locked in the laundry/office area. The facility files for residents and staff will be also kept locked in a cabinet in the office area. The resident’s medication will also be in a locked cabinet in the office area. The washer/dryer appear to be in good working condition. COMMON AREAS: The facility maintains a comfortable temperature at 75°F. The living room and dining area appeared clean and were properly furnished. No obstructions and or tripping hazards throughout the facility. LPA observed a working telephone for the facility. SURROUNDING GROUNDS: The facility has sufficient backyard space. LPA observed two set of outdoor furniture. Both set were observed to be under shaded areas for residents in care. There is no swimming pool or any bodies of water at the facility. The exit was blocked by a fridge and tables; however, during the visit all items were removed and LPA observed the exit to be free of any obstruction or hazard. Garage/Storage: The facility has a garage/storage which has an entry through the laundry/office and LPA observed to be locked and inaccessible to residents in care. SMOKE DETECTORS/CARBON MONOXIDE. Smoke detectors and carbon monoxide were located throughout the facility. At 11:10 AM, they were tested and observed to be operational. Component III was conducted with the Licensee/Administrator. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised and a copy of this report provided. Exit interview was conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Aug 27, 2025

Type of visit: Office

COMP II by CAB successfully completed Method: Phone Call at CAB Applicant/administrator participated in COMP II at CAB telephone call with analyst at CAB. Identification of the applicant and administrator was verified by presenting photo ID via phone. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, May 16, 2025