Future Senior Living 1

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Nelli Berberyan, and advised her of the visit. At approximately 9:30am, LPA took a tour of the physical plant. The facility is a one story building. Required postings were observed in the dining room and entry area. The smoke alarms and carbon monoxide detector are dual, hard wired and inter-connected. The facility has one new fire extinguisher, located at the front entry. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked cabinet. No cleaning supplies observed accessible during the day of the inspection. Bedrooms: There are six (6) bedrooms designated for residents to use. All six bedrooms are private rooms. All resident bedrooms are furnished with bed, chair, night stand, dresser and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. Bathrooms: The facility has two (2) bathrooms with grab bar and non-skid mats for residents and staff to use. Water temperature was within regulation ranging between 115°F – 117°F. All bathrooms were properly supplied and had functional fixtures. No cleaning supplies were observed in any of the bathrooms during the day of the inspection. Common Areas: These included the living room and dining room. The living has sufficient seating of a couch and coffee table. The dining room table is large enough to seat six. The television is positioned in the dining room area. Furniture were in good repair, and the floors were mopped and clean. Surrounding Grounds: The entrance to the home is gated, but it is not locked. The passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The right side of the facility has no access to the residents. There is an approved Accessory Dwelling Unit (ADU) on the right side of the facility. The ADU is for staff use only. The exterior left side and backyard of the facility is for resident use only and has sufficient yard space and furniture appropriate for outdoor use. Laundry area: The laundry room is located outside the home. Detergents and cleaning supplies are kept in a locked cabinet in the home. Staff Workstation/Office: There is a small staff work station located by the dining room table where staff and resident files are kept. Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications: The medication are kept locked in a cabinet in the living room area. Medications and medication records were reviewed for proper storage and documentation, Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted, and a copy of this report issued.the state’s words, verbatim · CDSS document, Jul 24, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with staff, Haukuhi, and explained the reason for the visit. The administrator, Nelli Berberyan, was notified over the telephone. At approximately 11:30am, LPA took a tour of the physical plant. The facility is a one story building. Required postings were observed in the dining room and entry area. The smoke alarms and carbon monoxide detector are dual, hard wired and inter-connected. The facility has one new fire extinguisher, located at the front entry. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked cabinet Bedrooms: There are five (5) bedrooms designated for residents to use. Bedroom #5 is a shared room, bedrooms #1 - #4 are private rooms. All resident bedrooms are furnished with bed, chair, night stand, dresser and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. Bathrooms: The facility has two (2) bathrooms with grab bar and non-skid mats for residents and staff to use. Water temperature was within regulation ranging between 110°F – 112°F. All bathrooms were properly supplied and had functional fixtures. No cleaning supplies were observed in any of the bathrooms during the day of the inspection. Common Areas: These included the living room and dining room. The living room has a couch and center table. The dining room is adjacent from the living room. Dining room table is large enough to seat six. The television is positioned in the dining room area. Furniture were in good repair, and the floors were mopped and clean. Surrounding Grounds: The entrance to the home is gated. The passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The right side of the facility has no access to the residents. There is an approved Accessory Dwelling Unit (ADU) on the right side of the facility, that has it's own private entrance. The exterior left side and backyard of the facility is for resident use only and has sufficient yard space and furniture appropriate for outdoor use. Laundry area: The laundry room is located outside the home. Detergents and cleaning supplies are kept in a locked cabinet in the home. Staff Workstation/Office: There is a small staff work station located by the dining room table where staff and resident files are kept. Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications: The medication are kept locked in a cabinet in the living room area. Medications and medication records were reviewed for proper storage and documentation, Garage: The garage is used for storage. It is kept locked at all times. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted, and a copy of this report issued.the state’s words, verbatim · CDSS document, Jul 17, 2025

Type of visit: Prelicensing

At 10:00AM Licensing Program Analyst (LPA), Antonia Alvizar-Ettima conducted an announced Pre-Licensing visit to the above facility and met with Administrator, Nelli Berberyan. An Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL). Fire Clearance was approved on 06/21/2024 for a maximum capacity of six (6) non-ambulatory residents, of which one (1) may be bedridden in bedroom #5. Waiver/Granted for hospice care for six (6) residents. The purpose of today’s visit is to inspect the facility to ensure that the physical plant is in compliance with rules and regulations of California Code of Regulations, Title 22, Division 6, Chapter 8. The facility is a single-story building in a residential community. The facility has one new fire extinguishers that was purchased on April 15, 2024. The fire extinguisher is located at the enters of the facility. A tour of the physical plant inside and outside was initiated at approximately 9:45am and the following was observed: KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, sink and stove. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6) residents. All knives and sharps are observed to be locked in a cabinet in the kitchen and inaccessible to residents. LAUNDRY ROOM: The laundry room is located outside the home. The washer/dryer appear to be in good condition. Laundry supplies are kept inaccessible when not in use in a locked cabinet in the home. BEDROOMS: There are five (5) bedrooms designated for residents to use. Bedroom #5 is a shared room, bedrooms #1 - #4 are private rooms. All resident bedrooms are furnished with bed, chair, nightstand, dresser and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. Auditory alarms were tested and observed to be operational. Continue on LIC809-C BATHROOMS: LPA inspected the bathrooms they are clean and in excellent condition located in the hallway. LPA observed two (2) bathrooms with grab bar and non-skid mats for residents and staff to use. Water temperature was within regulation ranging between 115.9°F – 116.4°F. LPA also observed sufficient quantity of toilet papers, soap and paper towels. COMMON AREAS: The facility maintains a comfortable temperature at 74°F. The living room has a couches, television and an ottoman with color books, crayons, markers, poker cards and puzzles. The dining area has a table and chairs that were clean and properly furnished. MEDICATION: The medication will be kept in a cabinet in the living room area. All medication will be locked inaccessible to residents. The facility staff/resident files will be kept in a locked cabinet in dining room area and inaccessible to residents. SMOKE DETECTORS/CARBON MONOXIDE. Eight (8) smoke detectors were located in the bedrooms and throughout the facility. Seven (7) out eight (8) smoke deters were dual carbon monoxide detectors and inter-connected. They were tested and observed to be operational. SURROUNDING GROUNDS: The entrance to the home is gated. The passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The right side of the facility has no access to the residents. There is an approved Accessory Dwelling Unit (ADU) on the right side of the facility, that has it's own private entrance, leaving no accessibility to the residents. The exterior left side and backyard of the facility is for resident use only and has sufficient yard space. LPA observed appropriate outdoor furniture, fruit trees with a covered shaded area for residents. LPA discussed the importance of maintaining the care and supervision to meet the needs of residents. There are no bodies of water. Component III: Upon review of the Licensing records, LPA noted that on 04/17/2024 the applicant representative/Licensee Nelli Berberyan completed the Component III during Pre-Licensing visit at facility “Future Senior Living #197610519” at which time the applicant was explained how to operate the facility within substantial compliance and had an opportunity to ask questions therefore, Component III was waived. Based on inspection and observation, the physical plant is in compliance with Title 22 Regulations at this time. This report will be forwarded to the Centralized Application Bureau (CAB) and the applicant will be notified by the CAB Analyst when your license has been approved. Exit interview was conducted and with a copy of this report was provided to Administrator.the state’s words, verbatim · CDSS document, Jul 16, 2024

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Name - Nelli Berberyan CEO/Administrator Interview Method: Telephone interview On April 15, 2024, Applicant/Administrator participated in COMP II for the following pending facilities: Future Senior Living/197610519; Future Senior Living I/197610517 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 15, 2024