Emvy Board and Care Facility

Type of visit: Required - 1 Year

Licensing Program Analyst(LPA) Christine Yee conducted an unannounced required Annual Inspection and used the complete CARE Inspection Tool. LPA Yee met with Emma Kochinyan, Administrator. The reason for today's visit was provided. The home is a single storey family home consisting of a living room, a dining room, a kitchen, a family room, 3 resident bedrooms, 2 bathrooms and a attached garage. The facility is fire cleared for 5 NON-AMBULATORY residents and 1 BEDRIDDEN resident. Based on the review of the rooms, Bedroom #3, located at the back right corner of the home, has an outside exiting door with a ramp and would be the room designated for bedridden use. All twelve domains of the CARE Inspection Tool, 3 Resident and 4 Staff files were reviewed on today's visit. A tour of the physical plant, inside and outside was also conducted. The following were observed: The living room, dining room, family room and kitchen were all furnished and equipped with the appropriate sitting for 6 residents, furniture and equipment for its designated use. The fire place located in the living room was observed with a fire screen. Bedroom #1 is currently rented as a private room, was observed with a bed, 3 armchairs, a night stand, a lamp, a dresser and a built in closet. The windows were observed with blinds for privacy. The second bed is stored in the attached garage. Bedroom #2 and Bedroom #3 were observed with 2 beds, 2 night stands, 2 lamps, 2 folding chairs a dresser and a built in closet. Also observed in bedroom #3 was an armoire. Half bed rails were continued on LIC809-C Page 2 observed on all the hospital beds except a full bed rail was observed on the right bed in bedroom #2. Resident #3 is on hospice. Bedroom #3 also has a direct exit leading out to a ramp. Bedroom #3 is currently vacant and the Licensee agreed to remove all the bed rails. Written physician's orders indicating the need for the half bed rails were observed for bedroom #2 and written physician's orders for the use of bed rails in bedroom #3 will be obtained for the residents if the half bed rails are required and will be maintained in the residents' file. Located inside Bedroom #3 is a full private bathroom. The bathroom has a walk in shower, a toilet and a single vanity sink. Grab bars were observed in the shower and by the toilet. A slip resistant mat was observed. The water temperature was tested and read 107.7 degrees Fahrenheit. The common bathroom is equipped with a walk in shower, a toilet and a single sink vanity. Grab bars in the shower, by the toilet, a shower chair and a slip resistant mat was observed. The water temperature was tested and read 113.7 degrees Fahrenheit. Sufficient perishable foods for a minimum of 7 days and non-perishable foods for a minimum of seven days were observed maintained on the premises. Medications are centrally stored in a locked kitchen cabinet. Extra Linens were observed in the hallway closet. The hardwired smoke detectors in the resident rooms, living room and the one combination smoke/carbon monoxide detector located in the resident hallway were tested and were operational. The 2 fire rated doors located in resident hallway and bedroom #3 did not activate when the smoke detectors were triggered. The auditory devices located on the front door, back door, kitchen door and bedroom #3 door were tested and were operational. The facility has 2 fire extinguishers, one located in the dining room and one in the garage, were last serviced on 4/29/26. The first aid kit was reviewed and contained a tweezer, scissors, thermometer, salves, band aids and gauze. A first aid manual was also observed. Cleaning solutions and disinfectants are stored in a locked cabinet under the kitchen sink and in the locked garage. Sharp knives are stored in a locked kitchen drawer Continued on LIC809-C Page 3. The facility telephone number was verified and is current as noted in the facility profile. Current general liability insurance expires on 8/19/26. Evidence of continuing coverage was requested from the broker and provided for policy term 8/19/26 - 8/19/27 during the visit. The policy limits meet Title 22 requirements - $1 million per occurrence and $3 million per annual aggregate. The garage houses the washer and dryer and is primarily used for storage A cover patio furnished with a table, seating for 6 and a swing chair was observed in the backyard. a second ramp was also noted from the backdoor exit. The 2 side gates were observed to be unlocked from the inside. Overall, the inside and outside of the facility, were observed to be clean. Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Immediate Civil Penalties of $500 were assessed. Exit interview was conducted, APPEALS RIGHTS were assessed and a copy was provided.the state’s words, verbatim · CDSS document, Aug 19, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst(LPA) Christine Yee conducted an unannounced required Annual Inspection and used the complete CARE Inspection Tool. LPA met with Emma Kochinyan, Administrator. The reason for today's visit was provided. The home is a single family home consisting of a living room, a dining room, a kitchen, a family room, 3 resident bedrooms, 2 bathrooms and a attached garage. The facility is fire cleared for 5 NON-AMBULATORY residents and 1 BEDRIDDEN resident. Based on the review of the rooms, Bedroom #3, located at the back right corner of the home, has an outside exiting door with a ramp and would be the room designated for bedridden use. All 12 domains of the Care Inspection Tool was reviewed, 4 resident and 4 staff files were reviewed on today's visit. The following were observed: The kitchen was appropriated equipped with a refrigerator, oven, microwave, coffee maker. The water temperature was tested and read 109.6 degrees Fahrenheit. Sufficient perishable food for a minimum 2 day and non-perishable foods for 7 days were observed. The dining room was observed with a table and 4 chairs. 2 dining room chairs were stored in the garage. One of the 2 chairs were broken. Located in the dining room is the only fire extinguisher. It was last serviced on 3/31/25. continued on LIC809-C Page 2 The living room was furnished with a sofa and love seat. The family room was observed with a sofa and a coffee table. The family room was observed with a sofa and a coffee table. Bedroom #1 is currently rented as a private bedroom and was observed with a hospital bed, a night stand, a chair, a lamp ***dresser and a built in closet Bedroom #2 and Bedroom #3 were both observed with 2 hospital beds, 2 night stands, 2 lamps and a built in closet. No chairs were observed in both rooms. Bedroom #2 does not have any dressers. Bedroom #3 has curtains but one panel is sheer and the licensee will replace with a solid panel for privacy. Extra linens were observed in the linen closet in the hallway. The private bathroom located inside Bedroom #3 is equipped with a walk in shower, grab bars, a slip resistant mat, a toilet and a single sink vanity. Water temperature was tested and read 109 degrees Fahrenheit. The common bathroom located by Bedroom #1 is equipped with a walk in shower, a shower chair, grab bars, slip resistant mat, a toilet, a single sink vanity. Water temperature was tested and read 108.4 degrees Fahrenheit. The hardwired smoke detectors located inside the residents' rooms, hallway, and in the living room were tested and were operational. The only smoke/carbon monoxide combination detector is located in the resident hallway. The facility has current general liability insurance that meets Title 22 requirements. Per file review, all staff have current first aid training. The Administrator was unable to provide evidence of CEUs for courses taken for Administrator recertification or a copy of current Administrator Certificate. Per file review, the Physician's report for Resident #2 indicates that the resident is bedridden due physical and mental capacity. However, per observation of Resident #2 , the resident is able to turn, able to straighten up the upper body when slumped over during sleep and is able to seat up when transferred to a chair. The facility is fire cleared for one bedridden and the designated room for bedridden use is Bedroom #3. Resident #2 was placed in Bedroom #1, which is fire cleared for continued on LIC809-C Page 3 non-ambulatory. No citations were issued during the visit pending clarification needed from Resident #2's physician regarding the residents ambulatory status. The Licensee will obtain an updated medical assessment from the doctor of Resident #2 and submit the final determination to the Department. Once clarification is obtained, any deficiencies as a result of Resident #2's placement in bedroom #1 will be addressed on a return visit. Per tour of the attached garage, it is primarily used for storage of extra furniture, wheel chairs, drinking water, cleaning solutions and houses the washer and dryer. Per tour of the facility, inside and outside, a covered patio with seating was observed in the backyard. A metal ramp from Bedroom #3 and another ramp from the dining room was observed. Also located on the patio was a second refrigerator that contained more perishable foods. An apple and pomegranate tree was observed in the backyard. The trash cans were observed on the curb for trash pick up. The outside areas were clean. Deficiencies were cited under California Code of Regulation, Title 22, Division 6, Chapter 8 Exit interview was conducted, APPEALS RIGHTS were discussed and a copy was given.the state’s words, verbatim · CDSS document, Aug 27, 2025

The state marks this report as 15 pages; the online copy we transcribed has 12. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 09:31 AM. LPA met with facility staff who contacted the facility administrator Emma Kochinyan via telephone call. Facility administrator arrived to the facility at 09:40 AM Entrance interview conducted and the reason for the visit was explained. Beginning at 09:40 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: KITCHEN: The LPA observed the kitchen area to be clean. Kitchen appliances were 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. The LPA observed the fire extinguisher to be fully charged and purchased on 03/08/2024. LPA observed a secured cabinet and a secured box located in the refrigerator to contain resident medication. BEDROOMS: There are three (3) bedrooms in the facility; all three (3) are designated for resident use. LPA and facility administrator toured all three (3) resident rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Bedroom number three (#3) contains a direct exit to the backyard. One resident bed was observed to contain full bed rails. Auditory alarms were observed on facility exits and were functional at the time of the visit. Report Continued on LIC 809-C BATHROOMS: There are two (2) bathrooms at the facility. Both bathrooms were observed to be clean and in good repair and all were equipped with nonskid surfaces. Grab bars were observed in all showers and near all toilets, all were properly secured. The water temperature was measured between 106.5 and 112.3 degrees Fahrenheit, which is in compliance with regulation. Both bathrooms were observed to contain unsecured personal grooming supplies for resident use. COMMON AREAS: This includes the living room, dining room, and a seating area. LPA observed the living room to be clean and properly furnished at the time of the visit. The living room contains an appropriately screened fireplace. Smoke detectors and carbon monoxide detectors were tested at 12:00 p.m. and were functional at the time of the visit. The dining room was observed to be clean and contains adequate seating for resident use. The seating room was observed to be clean with adequate seating and an appropriately screened fireplace. A closet attached to the seating room was observed to be unsecured and contained paint, painting supplies, and a box cutter. OUTDOOR SPACE/GARAGE: The facility has two (2) emergency exit gates, LPA observed clear passageways for emergency exit use. The facility has adequate shaded seating outdoors for resident use. Ramps were observed leading to the backyard from the dining room and bedroom number three (#3). All rails were secure and in good repair. LPA observed an extra refrigerator on the outdoor patio to contain extra food supplies. The garage was observed to be secured and contains a washer and dryer, cleaning chemicals, and extra care supplies. The garage contains adequate emergency food and water supplies. RECORD REVIEW: Record review began at 10:13 a.m. 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, TB tests, consent forms, and personal rights. Three (3) staff files were reviewed. All staff files contained the required documents. One (1) staff file reviewed was missing the required twenty (20) hours of annual training. Five (5) resident files were reviewed. All resident files reviewed contained all required documentation. Review of resident one’s (R1s) file revealed that they did not have a physician’s order for full bed rails. Report Continued on LIC 809-C MEDICATION REVIEW: Medication review began at 11:33 a.m. Medications are stored centrally and securely in a cabinet in the kitchen. Medications for two (2) residents were observed. Two (2) of two (2) centrally stored medication record sheets were missing some of the resident’s prescribed medications. 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. Last emergency disaster drill was conducted on 06/03/2024. 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 quarterly. INTERVIEWS: LPA interviewed one (1) staff and two (2) residents. All residents interviewed stated that the food was of good quality and is provided in sufficient amounts. All residents stated that staff treat them very well and are attentive to their needs. No residents interviewed had concerns with the facility. The staff member interviewed was knowledgeable on their roles and responsibilities, resident rights, the different forms of abuse and the appropriate reporting procedures for suspected abuse. During today’s visit LPA obtained a copy of the facility’s resident roster and liability insurance. The Pursuant to Title 22 of the CA Code of Regulations, and the Health and Safety Code, the following deficiencies were cited (refer to LIC 809-Ds): Citations were issued. Exit interview was conducted. today's report, and appeal rights were reviewed and issued.the state’s words, verbatim · CDSS document, Aug 30, 2024

The state marks this report as 9 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.