Otrium Care Homes

Type of visit: Prelicensing

At 09:15 am Licensing Program Analyst (LPA) Tihesha Smith conducted an announced pre-licensing visit at this facility. The licensee and administrators’ identity were verified by photo ID. The facility has a capacity of six (6) and there are two (2) residents in the facility. Purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with the rules and regulations of 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: The common areas (kitchen, living room, and dining areas were appropriately furnished, and lighting was adequate. The facility has a variety of adequate perishable and non-perishable food supply with emergency supply /water in hall closet near kitchen. Appliances in the kitchen appeared to be functional. The living room has a television and comfortable furniture. Games and activities for residents are stored on the console table. There is one (1) fire extinguisher: attached to living room wall next to tv and was observed to be fully charged. Dual Smoke and Carbon Monoxide detectors were observed all over the facility, tested, and observed to be operational at time of visit. An emergency exit plan/sketch is posted near front entrance wall with other posting requirements and additional sketch posting will be added to each room. There are two (2) bathrooms in the facility with one (1) of the bathrooms located inside the room. The hot water was tested for the bathrooms and measured 120 and 128.7 °F with cautions signs. Bathrooms have trash cans and bathroom has functional grab bars. (cont. to 809C) The sharps are stored and locked in drawer in kitchen under stove. Medications and first aid locked in stand-alone cabinet in office area next to kitchen and toxins locked in 2nd hall closet. Laundry is off the kitchen behind employees only door. The laundry appliances observed to be in good repair. Linens stored in hall closet next to main bathroom. There is no body of water at the facility. Backyard has a covered patio that is wheelchair accessible, has a large table, sufficient seating and is in good repair. The garage is attached (with no indoor entry) and used for facility storage. The following were discussed during the visit: Remodeling the main bathtub to shorten or make wheelchair accessible will not be pursued at this time. Flooring sections around door jamb and transition strip to be replaced/photos to be sent to LPA Smith. At the time of this visit the physical plant is meeting Title 22 requirements. Component III presentation completed at 11:30 am and administrator acknowledged understanding. No health and safety hazards were noted during this visit. Copy of this report will be forwarded to the CAB specialist. Exit interview was conducted and a copy of report was issued.the state’s words, verbatim · CDSS document, Feb 19, 2026

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 1 COMP II Participants: Bagrat Davtyan Member/ Levon Tunyan Administrator Interview Method: Telephone interview On January 21, 2026, 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 the 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 21, 2026