Glendale Heritage Home

Type of visit: Prelicensing

On 04/06/26, at 10:15am, Licensing Program Analyst Gina Saucedo conducted an announced Pre-licensing visit. LPA met with HOVHANNES SIRUNYAN, Administrator. An application was submitted to Community Care Licensing Division-CCLD on 10/2025, Initial license for a Residential Care Facility for the Elderly (RCFE), 60 years and older. The requested capacity is for six (6) non-ambulatory and the fire clearance was approved on 11/2025. Structure: This is a one-story single-facility with four (4) bedrooms and two (2) bathrooms and a backyard. Entrance: There is only one (1) entrance being utilized. Required postings such as: YES sign posted, Ombudsman sign, House Rules, Resident Council, Personal Rights and Administration Certificate against the wall of the facility on your left hand side. Toxins, cleaning solutions, and laundry detergents will be kept locked in a cabinet under the kitchen sink. Living/Dining area: The living room is neat, clean, and organized with sufficient seating for both residents and staff. Both areas are properly furnished and in good repair. The facility maintains a comfortable temperature between seventy (70) and seventy-one (71) degrees. No firearms observed or will be maintained on the premises. There is a working telephone on the premises. LIC809C-continued Resident/staff files: Resident and staff files will be kept locked in a filing cabinet in the office area. The office area is not part of the facility. LPA was still able to tour it. Kitchen: Sufficient supplies of dishes, cups, and silverware located within the kitchen cabinets and drawers. Sharps are stored on the left side of the kitchen locked and inaccessible to the residents. Kitchen appliances are working and are in good repair. Emergency: Fire extinguisher located in the entrance of the facility and dated 09/2025. Medications: The medication is currently kept in a top cabinet in the kitchen area locked and inaccessible to the current residents. First-aid kit will also be kept in this area. Bedrooms: The bedrooms are properly furnished with bed, nightstand, applicable lightening, and seating. Window coverings are in good repair, not broken or damaged. There are four (4) bedrooms-two (2) shared and two (2) single occupied. Bathroom: There are two (2) bathrooms are in proper condition and will be equipped with sufficient personal hygiene for each resident. Hallways: Hallway is properly lighted. The washer and dryer is located towards the back of the facility. Staff room: there is no designated staff room in the facility at this time. Water Temperature: The water temperature was measured in the bathrooms between 113.5 and 114.1 Fahrenheit and is within regulations. There are cameras in common areas and the facility has a signal system. LIC809C-continued Smoke detectors: Dual interconnected smoke detectors and carbon monoxide observed to be working properly and were tested. Garage: There is a no garage. Outside: There is a shaded area for residents. Pool: No bodies of water located at the facility. Administration: The facility had submitted an Emergency and Disaster Plan For Residential Care Facilities For The Elderly and Infection plan. The Component III Orientation RCFE-Residential Care Facilities Elderly was shown/reviewed with the Administrator. Facility is in compliance with Title 22 Regulations at this time. 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. Exit interview conducted and copy of this report issued to the administrator.the state’s words, verbatim · CDSS document, Apr 6, 2026

Type of visit: Office

COMP II by CAB successfully completed Facility Type: RCFE Application Type: INTL Capacity: 6 Census : 0 Method: Telephone call with CAB COMP II Participants: Sirunyan, Hovhannes (Licensee/Administrator), & Dianna Esparza(Analyst). Licensee & administrator participated in COMP II via Telephone call with CAB Analyst. Identification of licensee/administrator was verified by confirming driver’s license numbers. During COMP II, licensee/administrator confirmed the understanding of Title 22. Component II was successfully completed. Licensee/administrator were advised to email signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed licensee's/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, Jan 20, 2026