Chateau Magnolia

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced annual inspection at the facility. LPA met with the Karine Filikyan - Administrator and explained the reason for the visit. Residential Care Facility for Elderly (RCFE) is approved for six (6) non-ambulatory residents; six (6) of whom may be bedridden. Facility has an approved waiver for one (1) hospice resident. Current census is (5) five residents. At 11:05am, with the assistance of administrator, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarm/carbon monoxide detectors are battery operated and were tested and observed to function properly. The fire extinguisher is located in the kitchen and was purchased on 10/17/2025. Facility uses the front door as the main emergency exit. Additionally there are exit doors in the living/dining room, bedroom# 5 and #6. Facility conducts quarterly fire/earthquake drills. The last fire/earthquake drill was conducted on 01/20/2026. Kitchen: The kitchen appliances consisted of a refrigerator, oven and microwave. All appliances and kitchen surfaces were observed to be clean. LPA found a sufficient supply of perishable (2 days) and non-perishable (7 days) foods at the facility. There is a water filteration system in the kitchen. Knives and sharp objects were stored in the locked medication cabinet. Kitchen cleaning supplies and chemicals are being stored underneath the sink, in a locked cabinet. Common Areas: These included the living room/dining room and dining area in the kitchen. A glass covered fireplace was observed in the living room, but the facility does not use the fireplace. The common areas were properly furnished with tables, sofas and chairs, appropriate with number of residents and staff. The auditory alarms on all exit doors were observed and tested to be functional. Facility is equipped with cameras in the common areas. Facility offers land line telephone, cable and wi-fi access for residents' use. Continued on 809-C Bedrooms: There were five (5) bedrooms designated for residents' use and one (1) staff bedroom. There is always an awake staff member during night time. There is a sliding door in between bedrooms # 3 and #6 but bedroom #6 has a separate exit door for everyday access. The bedrooms in use by the residents were properly furnished with chairs, appropriate beddings and linens with sufficient lighting. Bathrooms: There are two (2) bathrooms designated for residents' use. One of the bathrooms is located inside bedroom #3. Both bathrooms have functional grab bars, non-skid mat, and fixtures. Hot water temperature in residents' bathrooms was measured 116.3 and 117.8 degrees Fahrenheit. Surrounding Grounds/Garage: The pathways to front yard and backyard were clear of obstruction. No body of water was observed. There is a covered patio, outside the living room and is furnished with a table and chairs, appropriate for number of the residents. Facility has a detached garage which currently is used as storage space. The laundry machines are located inside the garage. LPA observed the laundry cleaning supplies, hazardous chemicals, detergents locked in the garage, inaccessible to residents in care. LPA observed two extra refrigerators in the garage, supplied with perishable food supplies. Non-perishable emergency food supplies were also kept in the garage. Resident Files: LPA conducted a file review of all five (5) residents' records to ensure compliance of licensing forms. Medications: There is a locked cabinet in the kitchen, used to store medications. LPA observed a complete first aid kit and first aid manual in the medication cabinet. Medication and Medication Records were reviewed for proper documentation. Medications were counted for all five (5) residents to ensure administration based on physician orders. Staff Files: LPA also conducted a file review of three (3) staff records to ensure forms and training are up to date and in compliance with licensing forms. Administrator Certificate was reviewed with expiration date of 01/22/2027. Liability insurance was reviewed with expiration date of 11/17/2026. Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiencies were observed during the visit. Exit Interview Conducted / A Copy of the Report provided to the Administrator.the state’s words, verbatim · CDSS document, Apr 6, 2026

Type of visit: Required - 1 Year

At 9:15 AM Licensing Program Analyst (LPA) Nadia Shahbazian, conducted an unannounced annual inspection at the facility mentioned above. LPAs met with the Karine Filikyan - Administrator and explained the reason for the visit. The total capacity of the facility is approved for six (6) non-ambulatory residents; six (6) of whom may be bedridden. Facility has an approved waiver for one (1) hospice resident. Facility is a single-story house consisting of a total of six (6) bedrooms, two (2) full bathrooms. Current census is (4) four residents, including one (1) on hospice care. At 10:45am, with the assistance of administrator, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms and carbon monoxide detectors were tested and were functioning properly. The fire extinguisher is located in the kitchen. The charge date is 11/17/2024. Kitchen: The kitchen appliances consisted of a refrigerator, oven and microwave, and all fixtures were functional. LPA found a sufficient supply of perishable (2 days) and non-perishable (7 days) foods at the facility. Knives were stored in a drawer in the kitchen but the lock was broken. Staff immediately removed the knives and placed them in the locked medication cabinet in the kitchen. Kitchen clleaning supplies are being stored in the kitchen, underneath the sink but the lock was broken. Staff immediately removed and locked the chemicals in the garage, inaccessible to the residents. Bedrooms: There were five (5) bedrooms designated for residents' use and one (1) staff bedroom. The bedrooms in use by the residents were properly furnished with chairs, appropriate beddings and linens with sufficient lighting. One (1) of the bedrooms is currently vacant. Bathrooms: There are two (2) bathrooms, one (1) designated for residents' use and one (1) for staff use. Both bathrooms have functional grab bars, non-skid mat, and fixtures. Hot water temperature in residents' bathroom was measured at 117.8 degrees Fahrenheit. Common Areas: These included the living room, dining room and dining area in the kitchen. A properly covered fireplace was observed in the living room, even though the facility does not use the fireplace. The common areas were properly furnished with tables and chairs, appropriate with number of residents. The auditory alarms on all exit doors were observed and functional at the time of the visit. Facility is equipped with cameras in the common areas. Continued on LIC 809-C Garage: Facility has a detached garage which currently is used as storage space. The laundry is located inside the garage. LPA observed the laundry cleaning supplies, hazardous liquids, detergents locked in the garage, inaccessible to residents in care. LPA observed two extra refrigerators in the garage as well, supplied with perishable food supplies. Non-perishable emergency food supplies were also kept in the garage. Back Yard/Emergency exists: The main entry door is used for entrance/emergency exit door. LPA observed a locked back gate, exit doors in room #4, room #6, living room and an unlocked side door in the backyard. The pathways were clear of obstruction. No body of water was observed. Patio is covered and furnished with outdoor furniture, appropriate for number of the residents. Resident Files: LPA conducted a file review of resident records to ensure compliance of licensing forms. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and in compliance with licensing forms. Medications: Properly labeled medications were locked in one of the kitchen cabinets. A complete first aid kit and the first aid manual were also observed, together with the medications, in the kitchen cabinet. Medication and Medication Records for four (4) out of four (4) residents were reviewed for proper documentation and administration. Pursuant to Title 22 Division 6 of the CA Code of Regulations, deficiencies were cited (refer to LIC 809-D). Staff immediately corrected the deficiencies and the administrator will ensure staff are properly trained. Exit Interview Conducted / Appeal Rights Discussed / A Copy of the Report Issued.the state’s words, verbatim · CDSS document, Apr 16, 2025

Type of visit: Case Management - Health Checks

On 1/27/25, at 9:40am, Licensing Program Analyst, (LPA) Gina Saucedo, conducted an unannounced visit to the above facility to check on the residents who were evacuated due to the current fires that took place. LPA was greeted by Caregiver, Gohar Petrosyan and disclosed the reason for their visit. The Administrator, Karine Filikyan was called and arrived about twenty (20) minutes after. The facility originally accepted a total of three (3) residents from Eaton Canyon Villa I (197609785) and Eaton Canyon Villa II, INC (197610122). The facilities had a mandatory evacuation due to the fires. The residents transported to this facility were transported with their medication and additional staff to assist. A physical plant tour was conducted to ensure the health and safety of all residents. Two (residents) have been moved/transferred out from the above facility that were originally evacuated from the fires. There is only (1) resident that currently residing at the above facility. LPA observed the following: Facility is a single-story house consisting of a total of six (6) bedrooms, two (2) full bathroom and currently occupied with three (3) residents plus one (1) from the evacuation total of four (4). There is one entrance being utilized at the facility, there are required posters on your left side of the facility against the wall and the Ombudsman sign on your right-hand side. Smoke detectors and Carbon Monoxide detectors were tested and function properly. Relocated residents: There is one (1) resident that is still residing at the above address who has been placed in a single room with proper bedding, nightstand, chair, and lighting and television. LPA observed bedding and furniture in proper condition. Sufficient supplies of hygiene observed for the resident. LIC 809C-continued Bedrooms: The other three (3) residents’ from the above facility have their private bedrooms which are properly furnished and have adequate lighting and closet space. The bedrooms have appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, blankets and television. Bathrooms: LPA observed two (2) bathrooms to be clean, properly supplied and had functional fixtures. LPA observed grab bars in both bathrooms. The bathroom had non-skid mat in shower. The Kitchen: LPA observed sufficient stock of seven (7) day non-perishable and perishable foods. LPA observed enough chairs and tables in the dining area to accommodate the additional residents who were transferred. Administrator from the above facility stated they were able to provide their own food to the other residents that were transferred and to help accommodate during evacuation orders. Outside: There was a shaded area with proper furniture for outdoor use in the back patio. There are no bodies of water. Garage: There is also a garage in the back of the house. No Immediate Health and Safety issues observed. Exist interview conducted and a copy of this report was given to the Administrator.the state’s words, verbatim · CDSS document, Jan 27, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Antonia Alvizar conducted an unannounced Annual Required visit to this facility. LPA met with Administrator Assistant and explained the reason for the visit. At 1:50p.m. Administrator Assistant and LPA tour of the physical plant for compliance with safety, maintenance, and operational requirements. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Facility is a single-story house in a residential neighborhood and consisting of a common area, six (6) bedrooms, two (2) full bathroom and currently occupied with two (2) residents. There is one entrance being utilized at the facility, there are required posters at the main door. Smoke detectors and Carbon Monoxide detectors were tested and function properly. Facility disaster drills was conducted on 01/30/2024. The facility maintains a comfortable temperature at 72°F. Hot water temperature was tested in bathrooms and in the kitchen. The hot water temperatures measured between 117.3 - 118.5 degrees Fahrenheit (F) which are within the required range for residents comfort and safety. Kitchen: The kitchen appeared clean and fixtures functional. Kitchen knives and other sharp items are stored in a lock drawer in the kitchen. The supply of dishes and eating utensils was more than adequate. Resident medication, resident and staff records are kept locked in cabinet. All toxins are stored in a locked cabinet inaccessible to clients in care. Fully charged fire extinguisher is located in the kitchen. Bedrooms: The residents’ bedrooms were properly furnished and had adequate lighting and closet space. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. Continued from 809) Bathrooms: LPA observed all bathrooms to be clean, properly supplied and had functional fixtures. LPA observed grab bars in both bathrooms. The bathroom had non-skid mat in shower. Residents have enough personal hygiene supplies. Common Areas: The living room has a television, three (3) couch, three (3) recliner chairs and a functional telephone. The common areas were checked for cleanliness and furniture was checked for functionality. All areas were clean, sanitary and in good repair. Living room was observed to have a cover fireplace. At 4:00p.m. LPA observed residents resting in their bedroom. Surrounding Grounds (Outdoors): There was a shaded area with proper furniture for outdoor use in the back patio. There are no bodies of water and firearms on the premises. Garage: Detached located in the rear of the facility, which stores personal protected equipment (PPE), emergency food, maintenance supplies, resident diapers, extra personal hygiene, detergent, cleaning supplies, two (2) operation refrigerators with extra Non-perishable and perishable food. Garage is kept locked and inaccessible to residents at all times. Per California Code of Regulations (CCR), Title 22, Division 6, Chapter 8, deficiencies were not observed/cited. Exit interview conducted and copy of report provided to Administrator Assistant .the state’s words, verbatim · CDSS document, Apr 29, 2024