A Paradise Assisted Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA was greeted by Anna Hakobyan who is the licensee and was explained the reason for the visit. At 1:49 PM, with the assistance of licensee, LPA took a tour of the physical plant. Required postings were observed in the entry area. At 2:45 PM the smoke alarms were tested are operational that are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the living room with a charge date of (date). During the visit the facility is at 74 degrees Fahrenheit. The facility is fire cleared for six (6) non-ambulatory residents, of which one (1) may be bedridden in bedroom #1; hospice waiver for six (6). Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working electric stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the shed. Bedrooms: There were four (4) bedrooms designated for residents' use. Bedroom #1 and bedroom #3 all private used for residents and empty. Bedroom #2 and bedroom #4 are shared. Bedrooms were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Continue to LIC 809-C Bathrooms: There are three (3) bathroom designated for residents' use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 109.9 degrees Fahrenheit for bathroom #1 located in the hallway in between bedroom #1 and bedroom #2. Hot water temperature was measured at 110.8 degrees Fahrenheit for bathroom #2 located inside bedroom #3. Hot water temperature was measured at 106.3 degrees Fahrenheit for bathroom #3 located across bedroom #4. There was enough clean linen available in the cabinets in the hallway. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for six (6). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Furniture in common area was observed to be in good repair. There are no issues with Fire Clearance. Infection control: Facility mitigation plan to make sure licensee was following current infection control recommendations. LPA obtain a copy and reviewed the infection control plan during this visit. Surrounding Grounds: Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility does have a swimming pool it is fence up and lock. There is no garage only at the facility only a car port. Laundry service: There is enough linen available to change weekly or more if need. Cleaning supplies are being stored in a locked cabinet in the shed by the patio. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Records were checked for expired or missing certificates and clearances: LPA conducted a file review of staff for criminal record clearances and current First Aid. The administrator file was reviewed for current first aid, fingerprint clearance, administrator certificate, and HIV/AIDS and TB training. Continue to LIC 809-C Medications are in a centrally stored and locked place, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the clients’ doctor. Proper medication dispensing instruction are followed and checked for contamination. First-aid has all proper items and is current. Resident records were reviewed for requirements and legibility: LPA reviewed client’s files for current appraisal. Planned activities are offered. Facility is within CA code of Regulations Title 22 or Health and Safety Code. No deficiencies were found, exit interview conducted, copy of report has been issued and discussed.the state’s words, verbatim · CDSS document, Dec 2, 2025

Type of visit: Prelicensing

At 9:19am Licensing Program Analysts (LPAs), Leslie Ngo-Castaneda and Nadia Shahbazian conducted an announced pre-Licensing visit to the above facility and met with Licensee Anna Hakobyan. Fire Clearance was approved on 7/3/2024 for a maximum capacity of six (6) non-ambulatory residents, of which one (1) may be bedridden in bedroom #1; hospice waiver for six (6). 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 team touring the physical plant inside and outside and observed the following: KITCHEN: The kitchen is equipped with a refrigerator, microwave oven and sink. At 9:30 AM, the team observed adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. FIRE EXTINGUISHER was last purchased on 6/22/2024 is located in between the living room and the kitchen. First-aid is complete and new. BEDROOMS: There are four (4) bedrooms designated for client use. All bedrooms are furnished with beds, dresser and required bedding and linen. Extra linen is available in each bedroom. The bedrooms have sufficient closet space and have sufficient lighting. Auditory alarms were tested and observed to be operational. Facility will have awake staff. Bedroom #1 and bedroom #2 are for private use. Bedroom #3 and bedroom #4 are shared bedroom located at the end of the hallway. Continue to LIC 809-C BATHROOMS: At 9:45AM the team observed two and a half (2.5) bathrooms are clean and in good repair. Properly supplied with toilet papers, soap, and paper towels. The hot water temperature measured between 114.6°F. observed appropriate grab bar and had non-skid mat. Bathroom #1 is located in the hallway beside bedroom #4. Bathroom #2 is located inside bedroom #2 for private use. Hot water for bathroom #2 measured at 109°F. Bathroom #3 is located inside bedroom #1 for private use. Hot water for bathroom #2 measured at 111.1°F COMMON AREAS: The facility maintains a comfortable temperature at 72°F. The living room and dining appeared clean and were properly furnished. No obstructions and or tripping hazards throughout the facility. Office is located by the entrance, by the living room. MEDICATION: The medications will be kept in the kitchen cabinet and the team observed the cabinet kept locked and inaccessible to residents in care. SMOKE DETECTORS/CARBON MONOXIDE. Smoke detectors and carbon monoxide were located throughout the facility. At 9:30 AM they were tested and observed to be operational. SURROUNDING GROUNDS: In the back of the facility has sufficient yard space. LPAs observed appropriate outdoor furniture, with a covered shaded area for clients. The backyard is fenced. LPA discussed the importance of maintaining the care and supervision to meet the needs of clients. There is a swimming pool in the backyard that is locked and fenced. The driveway, passageway and entrance to the home was clear of obstructions. All entry and exit doors have a functional auditory alert when the doors open. NO GARAGE – there is only car port. In addition, LPAs observed laundry room is located at the end of the hallway of the facility beside bedroom #3. The washer/dryer appear to be in good condition. Laundry supplies are kept lock and inaccessible when not in use with supervision. Component III was conducted with the administrator and licensee. Facility is in compliance with Title 22 Regulations at this time. This report will be forwarded to the Centralized Application Bureau (CAB) and be notified by the CAB Analyst when your license has been approved. Exit interview was conducted and with a copy of this report was provided to the Applicant/Administrator.the state’s words, verbatim · CDSS document, Nov 18, 2024

Type of visit: Prelicensing

At 9:30am, Licensing Program Analyst (LPA), Leslie Ngo-Castaneda conducted an announced pre-licensing visit to the above facility and met with administrator Anna Hakobyan. LPA conducted an entrance interview with the Licensee. With the assistance of the Licensee LPA conducted a physical plant tour at 9:36AM, during the your LPA observed that licensee family still resides in the in the address. LPA advised licensee that this is not allowed since they can get a resident anytime when LPA approve of licensing. Licensee and LPA agreed to re-schedule pre-licensing.the state’s words, verbatim · CDSS document, Sep 12, 2024

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INTL Capacity: 6 Census : 0 Method: Telephone call with CAB COMP II Participants: Anna Hakobyan (Administrator/Licensee) & Tammy Edwards (Analyst). Administrator/Licensee participated in COMP II via telephone call with CAB analyst. Identification of the Administrator/Licensee was verified by confirming driver’s license number. During COMP II, Administrator/Licensee confirmed the understanding of Title 22. Component II was successfully completed. Administrator/Licensee was advised to email signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Administrator/Licensee'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, Aug 9, 2024