Ben Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 09:36 AM. LPA met with facility staff who contacted the Administrator Zhirayr Ayvazyan. The Administrator arrived to the facility at 09:55 AM. Entrance interview conducted and the reason for the visit was explained. Beginning at 10:00 AM, the LPA, along with facility Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: COMMON AREAS: This included the living room, laundry closet, storage room, and dining area. LPA observed the living room to contain adequate seating and an adequately screened fireplace. LPA observed the laundry closet to contain a washer and dryer and an appropriately secured cabinet which contained cleaning/laundry chemicals. LPA observed the hallway to contain a storage cabinet which contained extra care supplies. LPA observed the dining area to be clean and properly furnished at the time of the visit. The dining room contained a dining table with adequate seating for resident use and a fire extinguisher that was fully charged and purchased on 08/23/2025. All common rooms in the facility were observed to be clean and in good repair. The facility’s combination fire and carbon monoxide alarms were tested at 02:29 PM and were functional at the time of the visit. All exits in the facility were observed to contain functioning auditory alarms. BEDROOMS: There are three (3) bedrooms in the facility; two (2) are dual occupancy resident rooms and one (1) is a single occupancy resident room. LPA and facility administrator toured all three (3) bedrooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Bedrooms #2 & 3 contain direct exits to the outdoors of the facility. CONT. on LIC 809C. BATHROOMS: There are two (2) bathrooms at the facility. One (1) bathroom is designated as private resident bathroom, and one (1) bathroom is designated as a shared resident bathroom. Both resident bathrooms were observed to be clean and in good repair and were equipped with nonskid surfaces. Grab bars were observed in resident showers and near all resident toilets, all were properly secured. The water temperature was measured to be between 119.0 and 119.4 degrees Fahrenheit, which is in compliance with regulation. LPA observed both bathrooms to contain appropriately secured storages which contained personal grooming supplies for resident use. KITCHEN: The LPA observed the kitchen area to be clean. Kitchen appliances appeared to be in operable condition. The facility had a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. LPA observed a secured drawer which contained knives and other sharp objects. LPA observed a secured cabinet which contained resident medications and resident files. OUTDOOR SPACE: The facility has one (1) emergency exit gate located in the front yard. LPA observed clear passageways for emergency exit use. The facility has adequate shaded seating outdoors for resident use. LPA observed a deck and ramp at the back of the facility. The deck and ramp were equipped with sturdy railings and sufficient lighting. LPA observed clear passageways for emergency exit use. RECORD REVIEW: Record review began at 10:27 AM. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, consent forms, and personal rights. Four (4) staff files were reviewed. All staff files contained the required documents and trainings. Five (5) resident files were reviewed. All resident files were observed to contain all required documentation and signatures. No deficiencies were observed during record review. MEDICATION REVIEW: Medication review began at 11:24 AM. Medications for three (3) of five (5) residents were observed. All medications were stored properly and were documented on their respective centrally stored medication and destruction record sheets. CONT. on LIC 809C. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as they pertain to infection control are adequate. Emergency disaster drills are conducted quarterly; the facility’s last emergency disaster drill was conducted on 02/03/2026. The facility’s emergency disaster plan is up to date and is adequate. Both the infection control plan and the emergency disaster plan are reviewed/updated annually by the facility’s Administrator. INTERVIEWS: LPA interviewed two (2) residents. The residents interviewed stated that the staff treat them well and are attentive to their needs. Both residents interviewed had no concerns with the facility. LPA interviewed one (1) staff member; this interview was conducted with the assistance of the facility Administrator acting as a translator. The staff member interviewed was knowledgeable on the resident's rights, the forms of abuse, and the appropriate reporting procedures for suspected abuse. During today’s visit LPA obtained a copy of the facility’s updated emergency disaster plan, LIC 500, resident roster, and liability insurance. No deficiencies were observed during today’s inspection. Exit interview conducted and copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 19, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 09:16 AM. LPA met with facility administrator Zhirayr Ayvazyan. Entrance interview conducted and the reason for the visit was explained. Beginning at 09:17 AM, the LPA, along with facility Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: BEDROOMS: There are three (3) bedrooms in the facility; two (2) are a dual occupancy resident rooms and one (1) is a single occupancy resident room. LPA and facility administrator toured all three (3) bedrooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. BATHROOMS: There are two (2) bathrooms at the facility. One (1) bathroom is designated as private resident bathroom, and one (1) bathroom is designated as a shared resident bathroom. Both resident bathrooms were observed to be clean and in good repair and were equipped with nonskid surfaces. Grab bars were observed in resident showers and near all resident toilets, all were properly secured. The water temperature was measured at 118.7 degrees Fahrenheit, which is in compliance with regulation. LPA observed the private resident bathroom to contain an appropriately secured under-sink cabinet containing personal grooming supplies for resident use. Continued on LIC 809C. KITCHEN: The LPA observed the kitchen area to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. LPA observed a secured drawer to contain knives and other sharp objects. LPA observed a secured cabinet to contain resident medications and resident files. LPA observed a complete first aid kit and a fire extinguisher that was purchased on 11/12/2024. COMMON AREAS: This includes the living room, laundry room, storage room, and dining area. LPA observed the dining area to be clean and properly furnished at the time of the visit. The dining room contains a dining table with adequate seating for resident use. The living room was observed to be clean and in good repair. The living room contained adequate seating for resident use. LPA observed the living room to contain an adequately screened fireplace. A camera was observed in the living room, the Administrator informed LPA that the camera does not record audio. LPA observed the laundry room to contain a washer and dryer and an appropriately secured cabinet to contain laundry chemicals. LPA observed an appropriately secured storage room to contain cleaning supplies and extra care supplies. The facility’s combination fire and carbon monoxide alarms were tested at 11:33 AM and were functional at the time of the visit. All exits in the facility were observed to contain functioning auditory alarms. OUTDOOR SPACE: The facility has one (1) emergency exit gate located in the front yard. LPA observed clear passageways for emergency exit use. The facility has adequate shaded seating outdoors for resident use. LPA observed a deck and ramp at the back of the facility. The deck and ramp were equipped with sturdy railings and sufficient lighting. RECORD REVIEW: Record review began at 09:55 AM. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, consent forms, and personal rights. Five (5) staff files were reviewed. All staff files contained the required documents and trainings. Five (5) resident files were reviewed. All resident files were observed to contain all required documentation and signatures. No deficiencies were observed during record review. Continued on LIC 809C. MEDICATION REVIEW: Medication review began at 11:35 AM. Medications for four (4) of five (5) residents were observed. All medications were stored properly and were appropriately documented on their respective centrally stored medication and destruction record sheets. No deficiencies were observed during medication review. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills are conducted quarterly; the facility’s last emergency disaster drill was conducted on 02/02/2025. The facility’s emergency disaster plan is up to date and is adequate. Both the infection control plan and the emergency disaster plan are reviewed/updated annually by the facility’s administrator. INTERVIEWS: LPA interviewed three (3) residents. The residents interviewed stated that the staff treat them very well and are attentive to their needs. All residents interviewed were satisfied with the care the facility provides and had no concerns with the facility. LPA interviewed one (1) staff member; this interview was conducted with the assistance of the facility Administrator acting as a translator. The staff member interviewed was knowledgeable on the resident's rights, the forms of abuse, and the appropriate reporting procedures for suspected abuse. During today’s visit LPA obtained a copy of the facility’s LIC 500, resident roster, and liability insurance. No deficiencies were observed during today’s inspection. Exit interview conducted and copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 5, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sandra Urena arrived at the facility unannounced to conduct a required annual inspection. LPA Urena arrived at the facility and was greeted by staff. The administrator arrived shortly thereafter. The purpose of the inspection was discussed with the administrator Zhirayr Ayvazyan. LPA Urena and administrator conducted a tour inside and outside of the physical plant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. COMMON AREA: Common seating area and dining room furniture were observed to be in good condition. Fire extinguishers were observed to be serviced within the last year. There is a fireplace in the living room, which is screened and inaccessible. The facility maintained a comfortable temperature of 72 degrees. Smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguisher was purchase on 03/22/2023. The LPA observed required postings throughout the common space. The washer and dryer are locked in the hallway. Cleaning supplies and disinfectants are kept locked in the washer and dryer area. KITCHEN: Knives are stored in a locked cabinet drawer. Kitchen appliances were in operable condition. The facility has enough supply of perishable and non-perishable food. The freezer and refrigerator are stocked with a variety of foods. The emergency food supply is adequate for six residents and two staff. BEDROOMS: Bedrooms were furnished appropriately with appropriate furnishings and sufficient lighting. Linens are clean, and in good condition. BATHROOMS: Bathrooms were clean, shower area was in clean condition with grab bars and a non-skid mat available. Paper towels were available for drying hands. Hand washing signs were displayed, and sufficient amounts of soap and paper products in each restroom. Continues on LIC 809C... OUTDOOR: Backyard has a covered outdoor area equipped with furniture in good repair for residents’ use. There were no bodies of water noted. There is a side gate and is single-latched. RECORDS: Records review began at 3:00 p.m, Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. MEDICATIONS: Medications review began at 3:30 p.m.; medications are centrally stored and locked in a cabinet in the common area; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. INFECTION CONTROL: The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The LPA reviewed the following documents: - LIC500 Personnel Report - LIC9020 Client Roster No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 7, 2024