Hilltop Guest Home 2

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Administrator Christopher Bundalian. The facility's license shows a maximum capacity of five (5) non-ambulatory residents, of whom one (1) may be bedridden in Bedroom #5. Hospice waiver for four (4). During today’s inspection there were zero (0) residents in care. LPA with Administrator Bundalian toured the interior and exterior of the facility and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to residents. LPA observed locked storage for residents medications. No pools or bodies of water exist on the premises. Per Administrator Bundalian, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. First aid kits were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Administrator Bundalian to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Jan 14, 2026

Type of visit: Prelicensing

On 01/07/2025, at 12:20 PM, Licensing Program Analyst (LPA) Melody Brown conducted an announced visit to the facility for the purpose of a Prelicensing Visit. LPA Brown met with Administrator Christopher Bundalian. An initial application for license to operate a Residential Care for the Elderly facility (RCFE) was submitted to the Central Applications Bureau (CAB) on 10/27/2024 for a total capacity of five (5). Fire clearance was granted on 07/22/2024 for four (4) non-ambulatory residents and one (1) bedridden. LPA Brown observed the following: Structure: Facility was a one (1) level house with four (4) bedrooms for residents, one (1) bedroom for staff, three (3) resident/staff bathrooms, living room, dining area, laundry room and kitchen. There is an attached two (2) car garage. Heating/Cooling System: Central heating and air conditioning system installed with a central panel located in the hallway to control the entire house. Bedrooms: Each resident bedrooms accommodate any non-ambulatory resident, and bedroom #5 was approved for bedridden resident. All resident bedrooms were adequately furnished with bed, chair, closet, appropriate linens, adequate lighting, and an operable smoke alarm. Bathrooms: The three staff/resident bathrooms have a working toilet, wash basin, and tub & shower with non-slip mat with an adequate supply of toilet paper and soap. At 12:50 PM, LPA Brown tested the water temperatures in the resident/staff shared bathrooms. LPA verified water temperature was measured at 105.6 degrees Fahrenheit. ***CONTINUED ON LIC 809C*** ***CONTINUED FROM LIC 809*** Kitchen/Laundry: An adequate supply of dishes, glasses, utensils, pots, and pans were observed. Knives/sharp instruments were secured in a locked drawer located in the kitchen. There's adequate room for food storage. LPA Brown observed the stove to be operational. Refrigerator/freezer were in working condition. More than two (2) days supply of perishable foods and more than seven (7) days supply of non-perishable foods noted. There's an adequate seating for meals for all residents. Laundry room with washer and dryer was also observed. Laundry detergents and cleaning supplies are stored in the laundry room. Living/Family room: There's a living/family room with adequate seating for all residents and a working TV. Linens and Hygiene Supplies: An adequate supply of linens was stored in each resident bedrooms. Yards/Outside: Patio furniture for outdoor seating observed. Gate on the right side of the facility that leads into the backyard. All outdoor pathways were free of obstructions. Emergency Phone Numbers, and Exit Plan: Facility sketch was observed posted in the hallway and all resident rooms. Ombudsman poster, Let-Us-No poster, Personal Rights, House Rules, Visitation Policy, Rights of Resident Councils, Rights of Family Councils, Emergency Disaster Plan were noted posted in a common area. Dementia Care Plan: Dementia Care Plan was observed and reviewed during the visit today, 01/072025. General items: Two (2) fire extinguishers were charged and located throughout the facility. Eight (8) smoke alarms and one (1) carbon monoxide detector were tested and were observed to be in working order. Resident and staff records will be stored in a locked cabinet in the office room. First Aid kit with required components and first aid book, and locked area for medication storage was observed. LPA observed a facility phone and was operational as evidenced by LPA dialing the number. The phone number designated for the facility is 951-579-1271. ***CONTINUED ON LIC 809C*** ***CONTINUED FROM LIC 809C** There is enough Emergency water supply observed and the required 72-hour emergency food supply was observed from the regular food supply. Component III was completed on this day as well. Additionally, LPA Brown observed facility having the required single entry point with Sign In/Sign Out Sheet for Visitors and Residents, upon entering the facility. LPA Brown observed activities for the residents such as books and games and planned menu. The facility was evaluated in accordance with the California Code of Regulation (CCR), Title 22 Division 6 Chapter 8 to ensure the health and safety of residents in care. Facility appears to be ready for licensure. An exit interview was conducted, and a copy of this report, LIC809 was discussed and provided to Administrator Christopher Bundalian.the state’s words, verbatim · CDSS document, Jan 7, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 5 Interview Method: Telephone interview On 12/11/2024, 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 Pre-licensing readinessthe state’s words, verbatim · CDSS document, Dec 11, 2024