Sa Senior Living

Type of visit: Prelicensing

On 9.8.2026 Licensing Program Analyst (LPA) Leslie Ngo-Castaneda arrived at facility at 9:25 AM to conduct a pre-licensing inspection with the pre-licensing. Anna Sargsyan (licensee) was greeted upon entering the facility. An application to operate a Residential Care Facility for Elderly (RCFE) was received by Community Care Licensing (CCL) on 03.04.2026. A fire clearance was approved on 4.24.2026 for six (6) non-ambulatory, for a total capacity of six (6). At 9:51 AM, the smoke alarms and carbon monoxide detector were tested, they are hard wired and inter-connected. The facility has one (1) new fire extinguishers, located in the facility kitchen. A tour of the physical plant was initiated at approximately 9:25 AM and the following was observed: KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, microwave oven, and sink. There were adequate supplies of nonperishable food and dining ware to accommodate a maximum capacity of six (6). LPA inspected the kitchen and observed gas stove and refrigerator to be clean and working. Knives and sharps are stored in a locked drawer. Cleaning agents are also stored under the sink with a locking mechanism. BEDROOMS: There are three (3) bedrooms designated for residents use. Bedroom #1, bedroom #2, and bedroom #3 are shared. The applicant furnished the resident bedrooms with beds, night stand, dresser, bedding, and linen. The bedrooms have sufficient lighting and closet space. The linens were stored in the storage space in each residents bedrooms. Continue to LIC 809-C BATHROOMS: The facility has two and half (2.5) bathrooms. Staff bathroom, half bathroom (0.5) is located by the entrance of hallway. Private bathroom is located inside bedroom #2. The bathroom were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured at 108.1 degrees Fahrenheit. Bathroom #2 is located in between bedroom #1 and bedroom #3. Hot water delivered in the bathroom measured at 109.2 degrees Fahrenheit. COMMON AREAS: The common areas were appropriately furnished these included the living and dining room area. The living room was equipped with couch, tables and chairs. The LPA observed entertainment equipment and games for activities. The dining table is large enough to seat six (6) individuals. The facility has maintained a temperature of 69 degrees Fahrenheit. There were no visible immediate hazards. Water and emergency kits are stored in a cabinet in the kitchen. LAUNDRY ROOM: The laundry room is located by the hallway. The washer and dryer are observed to be operational. All chemicals were stored and locked by the laundry cabinet. MEDICATIONS: The medications will be located in the kitchen. It has a locking mechanism. OFFICE/STAFF WORKSTATION: The facility has a staff workstation that is in the living room by the dining table. The first-aid kit is complete. Designated files will be stored in the file drawer by the living room. Facility will provide 24 hour awake staff care. SURROUNDING GROUNDS: The passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. There is sufficient outdoor space with seating and a shaded area with proper furniture for outdoor use. There are no bodies of water on the premises. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensee. CAB will be advised, and a copy of this report provided. No health and safety hazard were noted during this visit. Licensee shall contact LPA once the first resident is admitted. Exit interview was conducted and a copy of report was issued. In addition to the pre-licensing inspection, a Component III power point presentation was also held.the state’s words, verbatim · CDSS document, Sep 8, 2026

Type of visit: Office

Facility Type:RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): 0 Method: Telephone call with CAB COMP II Participants: Sargsyan, Anna On 6/24/2026, the applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. 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. 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, Jun 24, 2026