Covello Homes

Type of visit: Required - 1 Year

At 12:10 PM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced Annual Inspection visit to the above facility and met with the staff who granted access to the facility. The staff contacted the Administrator Vardan Baghdasaryan via telephone and LPA explained the reason for the visit. The Administrator arrived shortly after. The facility is a single-story building. LPA conducted a physical plant tour of the facility inside and outside and observed the following: KITCHEN: At 12:30 PM, LPA toured the kitchen. The kitchen area is equipped with a refrigerator, microwave oven, sink. Stove was observed in a good working condition. LPA observed adequate supplies of perishable and nonperishable food. LPA observed a knife and a scissor in the dash rack, and two other knives in the kitchen cabinet accessible to residents in care. LPA observed other chemicals and toxins and were locked under the sink and inaccessible to residents in care. BEDROOMS: At 12:35 PM, LPA observed that the facility has six (6) bedrooms of which five (5) bedrooms are for resident’s use and one (1) designated for staff which is locked and inaccessible to resident. Bedroom # two (2), and one bed in bedroom # four (4) which is a shared room are currently vacant. LPA observed all bedrooms properly furnished with beds, dressers and required bedding, chest drawer, and linen. The bedrooms have sufficient closet space and have sufficient lighting. Facility have a live-in and an awake staff. Continue on LIC 809C Bathrooms: The facility has three (3) bathrooms. All bathrooms contained fully stocked soap, paper towels, trash can, non-skid mats, and grab bars. LPA observed trash cans with tight fitting lids, Hot water temperature measured at 116.6°F. Common Areas: The facility maintains a comfortable temperature at 70°F. The living room and dining area appeared clean and were properly furnished. The living room has a television, comfortable furniture. No obstructions and or tripping hazards throughout the facility. Smoke detectors/carbon monoxide. Smoke detectors were located throughout the facility and are hard-wired. At 12:45 PM they were tested and observed to be operational. Carbon monoxide was located in a hallway and was also tested and observed to be operational. Outside space: LPA observed a covered area with with furniture in good repair. All outdoor spaces and paths were free from obstructions. The exit door was observed with inward latch that can be easily opened and accessible. Garage: LPA observed a garage with adequate incontinence supplies and with a working washing machine and dryer. LPA observed all cleaning supplies and detergents locked in the garage and inaccessible to residents in care. Medication: LPA observed that medication are kept in a cabinet next to the kitchen and was locked and inaccessible to residents in care. There was a complete first aid kit located in the medical supply cabinet by the dinning area. Between 1:10 PM to 2:15 PM, LPA reviewed records of four (4) residents and one (1) staff. Residents and staff records appeared to be complete and updated. LPA reviewed medication and did not observe any discrepancy. Administrative: LPA collected Certificate of Liability Insurance, and LIC500. No deficiency issued during today's visit. Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Aug 18, 2026

Type of visit: Required - 1 Year

At 9:45 AM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced Annual Inspection visit to the above facility and met with the staff Ronald Lasam. The staff contacted the Administrator Vardan Baghdasaryan via telephone and LPA explained the reason for the visit. The Administrator arrived at the facility at 10:15 AM. The facility is a single-story building. LPA conducted a physical plant tour of the facility inside and outside and observed the following: KITCHEN: At 10:20 AM, LPA toured the kitchen. The kitchen area is equipped with a refrigerator, microwave oven, sink. Stove was observed in a good working condition. LPA observed adequate supplies of perishable and nonperishable food. LPA observed a knife and a scissor in the dash rack, and two other knives in the kitchen cabinet accessible to residents in care. Furthermore, LPA observed a Lysol disinfectant spray on the top of the medication cabinet which is placed next to the kitchen and LPA also observed vitamins and supplementals in one of the kitchen cabinets unlocked and accessible to residents in care.LPA also observed other chemicals and toxins and were locked under the sink and inaccessible to residents. BEDROOMS: At 10:25 AM, LPA observed that the facility has six (6) bedrooms of which five (5) bedrooms are for resident’s use and one (1) designated for staff which is locked and inaccessible to resident. Bedroom # two (2), and bedroom # three (3) are currently vacant. In bedroom #5 LPA observed medication of Resident #2 (R2) accessible and unlocked to residents in care. LPA observed all bedrooms properly furnished with beds, dressers and required bedding, chest drawer, and linen. The bedrooms have sufficient closet space and have sufficient lighting. Facility have a live-in and an awake staff. Continue on LIC 809C Between 11:40 AM to 1:15 PM, LPA reviewed records of four (4) residents and three (3) staff. Residents and staff records appeared to be complete and updated. Administrative: LPA collected Certificate of Liability Insurance, and LIC500. Deficiencies were issued today’s visit. Appeal right explained. Exit interview conducted and copy of this report signed and delivered. Bathrooms: The facility has three (3) bathrooms. All bathrooms contained fully stocked soap, paper towels, trash can, non-skid mats, and grab bars. LPA observed trash cans with tight fitting lids, Hot water temperature measured at 118.4°F. In two (2) out of three (3) bathrooms LPA observed disinfectant wipes accessible to residents in care. Common Areas: The facility maintains a comfortable temperature at 71°F. The living room and dining area appeared clean and were properly furnished. The living room has a television, comfortable furniture. No obstructions and or tripping hazards throughout the facility. Smoke detectors/carbon monoxide. Smoke detectors were located throughout the facility and are hard-wired. At 11:30 AM they were tested and observed to be operational. Carbon monoxide was located in a hallway and was also tested and observed to be operational. Outside space: LPA observed a covered area with with furniture in good repair. All outdoor spaces and paths were free from obstructions. The exit door was observed with inward latch that can be easily opened and accessible. Garage: LPA observed a garage with adequate incontinence supplies and with a working washing machine and dryer. LPA observed that garage was unlocked and all the laundry detergents and Colorax Beach were accessible to residents in care. Medication: LPA observed that medication are kept in a cabinet next to the kitchen and was locked and inaccessible to residents in care. During review of R3's random medication revealed that the facility was supposed to start Atorvastatin (High Cholesterol Medication) a new bottle on 05/03/2025. During today's visit LPA counted R3's medication and it was discovered that there was a discrepancy and ten (10) extra pills were in the bottle. LPA asked the Administrator and the staff for explaining and both staff could not provide sufficient information as to why there were extra pills. LPA also observed Centrally Stored Medication (LIC 622) records and did not observe a current/updated medication record with all the required information. There was a complete first aid kit located in the medical supply cabinet by the dinning area. Continue on LIC 809Cthe state’s words, verbatim · CDSS document, May 12, 2025

Type of visit: Prelicensing

At 9:00 am, Licensing Program Analyst (LPA), Huma Rahimi conducted an announced Pre-Licensing visit to the above facility and met with Administrator. LPA conducted an entrance interview with the Administrator. At the time of this visit LPA did not observe any residents present in the facility. Fire Clearance dated 02/27/2024 and received for six (6) Bedridden residents. 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. The facility is a single-story building. LPA toured the physical plant inside and outside and observed the following: KITCHEN: At 9:15 LPA toured the kitchen. The kitchen area is equipped with a refrigerator, microwave oven, sink. Stove was observed in a good working condition. LPA observed adequate supplies of nonperishable food and dining ware to accommodate a maximum capacity of six (6). All knives and sharps are observed to be locked in the kitchen in a cabinet. Chemicals and toxins were locked under the sink and inaccessible to residents. BEDROOMS: At 9:22 AM, LPA observed tha the facility has six (6) bedrooms of which five (5) bedrooms are for resident’s use and one (1) designated for staff which will be locked and inaccessible to clients. Bedroom # one (1), bedroom # two (2), bedroom # three (3), and bedroom # five (5) are private. Bedroom # four (4) is shared. Bedroom # one (1) and bedroom # two (2) were occupied. LPA observed all bedrooms properly furnished with beds, dressers and required bedding, chest drawer, and linen. The bedrooms have sufficient closet space and have sufficient lighting. Facility will have a live-in staff at the facility. LPA did not observe any obstruction or hazard. Continue on LIC 809C BATHROOMS: At 9:23 AM, LPA observed three (3) bathrooms. There are two (2) private bathrooms in bedroom # one (1) and bedroom # four (4). The shared bathroom is in the hall by bedroom # two (2) and bedroom # three (3). All bathrooms are clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed to have an appropriate non-skid mat. At 9:25 AM, the water temperature was noted at 120°. COMMON AREAS: LPA observed all common area to be clean in good repair. The facility maintains a comfortable temperature at 72°F. The living room and dining rooms were properly furnished. No obstructions and or tripping hazards throughout the facility. The living room has a screened fireplace. There is a dinning table which can accommodate six (6) residents. MEDICATION: Facility has a separate locked refrigerator for resident’s medication. The fridge is located in the dining room behind the dining table. Medications that do not require refrigeration will be kept in the locked cabinet by the kitchen. LPA observed two additional locked cabinets for staff and resident’s files as well as additional over the counter medications in the dining room. LAUNDRY ROOM: The laundry room is in the garage. LPA observed the washer and dryer are in good repair. The garage has a locked cabinet where the laundry detergents are locked and inaccessible to residents in care. The garage is used as a storage for equipment, emergency supply, and water. SURROUNDING GROUNDS: The facility has a backyard and has sufficient space. LPA observe appropriate outdoor furniture, and a covered shaded area for clients. There is no swimming pool or any bodies of water at the facility. The facility has one emergency exit and LPA observed to be free of hazard. SMOKE DETECTORS/CARBON MONOXIDE. Smoke detectors and carbon monoxide were located throughout the facility. At 9:40 AM, they were tested and observed to be operational. At 9:45 AM, LPA observed a full Fire Extinguisher hanging next to the kitchen wall and was last serviced on 07/11/2023. Continue on LIC 809C Between 10:30 AM, to 11:10 am, LPA reviewed records of two (2) residents and one (1) staff. LPA observed that resident # 1 (R1) file was under the new or to be facility’s name. Administrator agreed to change the file under the current facility’s name and number. Once the Administrator submit the file change, LPA will inform CAB Analyst for license approval. Component III was conducted with the Administrator. Pursuant to Title 22, the facility is compliant to regulation, is not ready for licensure. This report will be forwarded to the Centralized Application Bureau (CAB). The applicant will be notified by the CAB Analyst when their license is approved. Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, May 2, 2024

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 1 COMP II Participants: Name - Vardan Baghdasaryan CEO/Administrator Interview Method: Telephone interview On April 10, 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 the 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, Apr 10, 2024