Acton Senior Housing Care

Type of visit: Required - 1 Year

On 06/03/2026 at 01:00 pm Licensing Program Analyst (LPA) Lorena Casillas met with Licensee Suren Galstyan for an unannounced one (1) year required visit for this facility. LPA was greeted and granted access by Administrator. LPA explained the reason for the visit and an entrance interview was conducted. The facility is fire cleared for five (5) non-ambulatory residents and one (1) bedridden resident for a total capacity of six (6). Currently there are no residents living in the facility. Infection Control and Emergency Preparedness Plan: LPA reviewed facility Infection Control Plan and Emergency Preparedness Plan to make sure protocols are being reviewed and/or updated. Plans were discussed and updated. The tool kit was not used, as there are no residents in the facility yet. A tour of the physical plant was initiated at approximately 01:30 pm and the following was observed: Kitchen: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There was an adequate supply of nonperishable food and dining ware to accommodate a maximum capacity of six (6). Perishable food will be purchased once residents are established. Knives will be locked in a kitchen drawer. Continued on LIC809-C Bedrooms: The facility has a total of four (4) bedrooms of which three (3) are for resident use and one (1) bedroom for staff use. Bedrooms #1 through #3 are designated for two (2) non ambulatory residents each. Bedroom #3 can be used for one (1) bedridden resident. Bedroom #4 is for staff use. The applicant furnished the resident bedrooms with beds, nightstand, chairs, dresser, bedding and linens. All rooms had sufficient lighting. Bathrooms: The facility has three (3) bathrooms. All bathrooms were observed to have the proper fixtures, and non-skid mats. The hot water delivered in the bathrooms measured 118.2 degrees F. Common Areas: These included the living room and dining room areas, which were equipped with living room furniture, a television, tables, and chairs. The dining room table is large enough to accommodate up to six (6) residents. There were no visible immediate hazards. The smoke alarms are hard wired, inter-connected and are a combination with carbon monoxide. The facility has two (2) fire extinguishers that were purchased on 11/25/2024 and are fully charged. One is located in the kitchen and one in a hallway. Licensee will purchase new extinguishers and will send LPA confirmation. Laundry Room: Laundry room is adjacent to the staff bedroom and has washer and dryer. Cleaning detergents and supplies are locked in the laundry room. Medication: Medication and first aid kit will be stored in a locked cabinet in the kitchen area. Garage: The garage is used for storage. Administrative: Administrator Certificate and Liability Insurance will be emailed to LPA. Annual fees are not current but Licensee stated that this will be paid as soon as possible and will email proof to LPA. Licensee is debating on keeping facility open as they do not have any residents. LPA explained that the fees still need to be paid on time. Licensee expressed understanding. Resident & Staff Files: LPA did not conduct a file review as there are no residents or staff. Staff & Resident Interviews: LPA did not interview staff or residents. No citations issued. Exit interviewed conducted and a copy of the report was provided to the Licensee.the state’s words, verbatim · CDSS document, Jun 3, 2026

Type of visit: Prelicensing

On 02/25/2025 at 09:45 am, Licensing Program Analyst (LPA) Lorena Casillas conducted an announced Pre-Licensing Inspection with Licensee Suren Galstyan and Administrator Hasmik Kachatryan. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 09/03/2024. A fire clearance was approved on 10/25/2024, for five (5) non-ambulatory residents and one (1) bed ridden resident for a total capacity of six (6). The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6. The Component III presentation was conducted from 10:05 am until 11:35 am with Licensee and Administrator. A tour of the physical plant was initiated at approximately 11:45 am and the following was observed: The facility maintains a comfortable temperature of 78 degrees F. KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There was an adequate supply of nonperishable food and dining ware to accommodate a maximum capacity of six (6). Perishable food will be purchased once residents are established. Knives will be locked in a kitchen drawer. BEDROOMS: The facility has a total of four (4) bedrooms of which three (3) are for resident use and one (1) bedroom for staff use. Bedrooms #1 through #3 are designated for two (2) non ambulatory residents each. Bedroom #3 can be used for one (1) bedridden resident. The applicant furnished the resident bedrooms with beds, nightstand, chairs, dresser, bedding and linens. All rooms had sufficient lighting. Continued on LIC809-C BATHROOMS: The facility has three (3) bathrooms. All bathrooms were observed to have the proper fixtures, and non-skid mats. The hot water delivered in the bathrooms measured 119.6 degrees F. COMMON AREAS: These included the living room and dining room areas, which were equipped with living room furniture, a television, tables, and chairs. The dining room table is large enough to accommodate up to six (6) residents. There were no visible immediate hazards. The smoke alarms are hard wired, inter-connected and are a combination with carbon monoxide. The facility has two (2) fire extinguishers that were purchased on 11/25/2024 and are fully charged. One is located in the kitchen and one in a hallway. LAUNDRY ROOM: Laundry room is adjacent to the staff bedroom and has washer and dryer. Cleaning detergents and supplies are locked in the laundry room. MEDICATIONS: Medications and first aid kit will be stored in a locked cabinet in the kitchen area. GARAGE: The garage is used for additional storage. STAFF/RESIDENT RECORDS: Staff and resident records will be stored in a locked cabinet, located in the living room. The applicant was advised to ensure that resident and staff records will be accessible to the licensing agency upon request or during inspection. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. The backyard of the facility has a patio and backyard furniture. The facility backyard has sufficient yard space to accommodate outdoor activities. There is no swimming pool or bodies of water. No deficiencies noted. Exit Interview was conducted, and a copy of this report was given to Administrator.the state’s words, verbatim · CDSS document, Feb 25, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Method: Telephone call with CAB COMP II Participants: Galstyan, Suren & Khachatryan, Hasmik On 2/10/25, 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, Feb 10, 2025