Friendship Village Rcf

Type of visit: Required - 1 Year

LIcensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection and used the CARE Inspection Tool to conduct the visit. LPA Yee was let into the home by Lilliana Faure, Staff. Also present was Renier Zapanta, Staff. LPA Yee contacted Vahe Mkrtchian via telephone and he arrived a little later to conduct the visit. The reason for today's visit was provided. The facility is a single storey family home consisting of a living room, dining room, kitchen, 5 bedrooms of which one is used for live-in staff, 2 common bathrooms and a attached garage. The facility is fire cleared for 5 NON-AMBULATORY and 1 BEDRIDDEN resident. Bedrooms #1 - Bedroom #4 may be used for the one bedridden resident. The facility has been approved for 6 hospice waivers. On today's visit, the entire CARE Inspection Tool was reviewed, Resident and Staff files were reviewed and a tour of the physical plant, inside and outside was conducted and the following were observed: Bedroom #1 and Bedroom #4 are private rooms and were furnished with one bed, chair, night stand, one lamp, one dresser and a built in closet Bedroom #2 and Bedroom #3 are shared rooms and were furnished with two beds, two chairs, one night stand, one lamp, a built in closet. Sufficient lighting was observed from the overhead lights. The required bed linens were observed on the beds, in the linen closet and in the garage. Towels were observed in the bedrooms and in the garage. All the facility windows were observed with blinds for privacy. Continued on LIC809-C The 2 common bathrooms, one located by the front hallway and one located in the back, were both equipped with a walk in shower, a toilet and a sink. Grab bars were observed in the shower and by the toilet. A slip resistant mat and a shower chair were also observed. The water temperature tested in the front bathroom read 118.4 and the back bathroom 118.3 degree Fahrenheit. The living room was observed with a sofa and 3 arm chairs, a television stand, a mounted television and a sign in table. The dining room is furnished with a table and 6 chairs. The kitchen is equipped with a refrigerator, a microwave and a dishwasher. Sufficient perishable foods for a minimum of 2 days and non-perishable foods for a minimum of 7 days were observed on site. The only fire extinguisher purchased on 10/3/25 is located in the kitchen by the back door. The fire rated door separating the living room from the resident bedrooms was observed to close tightly. The first aid kit containing the required tweezer and scissors,gauze and bandages and an external thermometer were observed. A first aid manual was also observed. The auditory devices on all outside exiting doors were tested and were operational. The hardwired smoke detectors were tested and were operational. The attached garage is primarily used for storage and is always kept locked. The back yard contains a covered patio and houses the washer, dryer and 2 chairs were observed. The backyard and the sides of the home is well maintained. The front of the house has a covered patio and is furnished with wicker chairs and a coffee table for activities. The front yard is well maintained. The trash cans were observed on the curb for pickup the following day. No deficiencies were cited on today's visit. Exit interview was conducted and a copy of the report was provided.the state’s words, verbatim · CDSS document, Nov 17, 2025

Type of visit: Required - 1 Year

(PAGE 1) Licensing Program Analyst (LPA) Erica Mosley arrived at the facility unannounced to conduct a required annual visit at 10:00 a.m. Upon arrival, there was two (2) staff and five (5) residents present. Staff called Administrator and arrived shortly after. The LPA met with Administrator Vahe Mkrtchian and explained the reason for the visit. The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. KITCHEN: The LPA toured the kitchen/food service area at 10:26 a.m. The hot water was measured at 114.4 degrees Fahrenheit at 10:30 a.m. within the required range. The kitchen appeared clean and the appliances and fixtures functional. Refrigerated and frozen foods were stored at proper temperature. There was a sufficient supply of two (2) day perishable and seven (7) day non-perishable food. The facility also received a food delivery during the visit. Administrator stated they have groceries regularly delivered on Fridays. Food labels were inspected and checked for dates and expiration dates. Food had labels clearly marked with dates. Knives and sharps were observed locked in a cabinet. Cleaning supplies were stored under the kitchen sink locked and inaccessible. There were no pesticides or poisons observed near any food areas. An adequate supply of emergency food is located in the bottom cabinet in the kitchen. (Report Continued on LIC 809C 2ND PAGE) (PAGE 2) (Report Continued from LIC 809 PAGE 1) LIVING ROOM/DINING ROOM/ COMMON SPACE: The LPA inspected the living room and dining room area. The common areas were observed to be properly furnished and clean at the time of the visit. Furniture was observed to be in good condition. The facility maintained a comfortable temperature. At 11:36 a.m., the hardwired smoke detector(s) and carbon monoxide detectors were tested and operational. Fire extinguisher was observed fully charged and purchased on 12/13/2023. The LPA observed required postings throughout the common spaces. The facility has a working telephone on premises. Auditory alarms on all doors were functional at the time of the visit. Entry/exits were free of obstruction. The last emergency disaster drill took place on 08/27/2024 and are conducted quarterly. Activities were observed in the common areas. There was a linen closet in the hallway with extra towels and linens. Cleaning supplies and toxins were observed in the hallway closet which remains locked, and inaccessible to residents in care. GARAGE /OUTDOORS: There is a garage that is kept locked and inaccessible at all times and is used as storage. The LPA observed a sufficient supply of Personal Protectant Equipment (PPE). The front yard has a shaded area with furniture for resident use. The backyard also has a shaded area with chairs and physical activity equipment such as a stationary bike for resident use. The LPA observed two (2) gates that self-latches with a clear passageway in case of an emergency. There were no bodies of water noted at the time of the visit. There is a washer and dryer on the premises. BEDROOMS: There are five (5) total bedrooms in the facility, two (2) are designated as shared, double occupancy resident bedrooms, two (2) are designated as private, single occupancy resident bedrooms, and one (1) staff room which remains locked at all times. The resident bedrooms were properly furnished with a bed, nightstand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. BATHROOMS: There are two (2) shared bathrooms for resident use. Resident bathrooms were clean, sanitary and in operating condition with grab bars and non-skid surfaces. The hot water was measured in both bathrooms. The first bathroom measured at 109.1 degrees Fahrenheit at 10:38 a.m. and the second measured at 111.6 degrees Fahrenheit at 10:40 a.m. both within the required range. (Report Continued on LIC 809C... 3RD PAGE) (PAGE 3) (Report Continued from LIC 809C 2ND PAGE) RECORDS: Records review began at 10:43 a.m., five (5) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. All files were in order at this time. Four (4) Personnel records and Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. MEDICATIONS: Medications review for five (5) residents began at approximately 11: 45 a.m. Medications are centrally stored in a locked closet in the hallway inaccessible to residents in care. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs have physicians order on file. Medications are labeled and checked for expiration dates. No medication errors observed at this time. The facility uses an application called ALCOMY which documents medication and is used by all staff. The LPA interviewed one (1) staff, two (2) residents during the inspection. During today’s visit, the LPA obtained copies of the following: LIC 500 Personnel Report, LIC 9020 Resident Roster, and current liability insurance. No deficiencies cited at this time. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Nov 15, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst(LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool and met with Vahe Mkrtchian, Administrator. The reason for today's visit was explained. The facility is a single storey family home consisting of a living room, dining room, kitchen, 5 bedrooms of which one is used for live-in staff, 2 common bathrooms and a attached garage. The facility is fire cleared for 5 NON-AMBULATORY and 1 BEDRIDDEN resident. Bedrooms #1-Bedroom #4 may be used for the one bedridden resident The following was observed on today's visit: the living room, dining room and kitchen have the appropriate furnishings and equipment all 4 of the resident rooms have the required furniture and most of the bed linens. No blankets or flat sheets were observed on any of the beds or extra linens in the linen closet. All the exit doors are equipped with auditory devices. The auditory devices in Bedroom #1 and Bedroom #2 were not operational. Batteries were replaced during the visit. Sufficient perishable foods for 2 days and non-perishable foods for 7 days were observed. Medications and hygiene products were observed stored in 1 locked hallway closet and the toxins in another closet. Additional cleaning supplies are stored in a locked cabinet under the kitchen sink. the 2 common bathrooms are equipped with a shower, a toilet and a sink. Grab bars and non-skid mats were observed. The water tested in the front bathroom read 119.3 degrees Fahrenheit and the water temperature in back bathroom read 120 degrees Fahrenheit. the only fire extinguisher located in the kitchen was purchased on 10/30/22 and a new will be purchased prior to expiration date. the facility has a first aid kit with the required tweezer and scissors and a common thermometer. No first aid manual was observed. the facility has a land line with a telephone # (818)358-3286 the facility has current liability insurance that meets the required $1 million per incident for a total annual aggregate of $3 million. the smoke/carbon monoxide combination detectors located in the resident bedrooms and in the hallway are hardwired and were tested and were operational. Per tour of the outside, both the front and back of the facility has a covered patio with seating for residents and were observed to be clean and well maintained. Located in front of the home, along the left side of the facility and the back are ramps that allow residents direct access to the outside trash cans located in the front were observed tightly sealed. all staff and resident records were reviewed during today's visit Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Exit interview was conducted, APPEALS RIGHTS were discussed and a copy was giventhe state’s words, verbatim · CDSS document, Oct 25, 2023