G & A Boarding Care

Type of visit: Required - 1 Year

At 09:30 AM, Licensing Program Analyst (LPA), Huma Rahimi conducted an unannounced annual visit to the above facility and met with the staff #1 (S1) Lina Teprjian and the Administrator Gregor Greg Shamamyan, was contacted via telephone. LPA explained the reason for the visit. Administrator arrived shortly after. The facility is cleared for five (5) Non-ambulatory, and one (1) Bedridden (room #4) residents. The facility is a single-story building with four (4) bedrooms and two bathrooms for residents use. During today's site visit LPA and S1 toured the facility inside and out and observed the following: KITCHEN: The kitchen area that is equipped with a refrigerator, microwave oven, and a sink. Stove was observed in a good working condition. At 09:35am, LPA observed adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). All knives were observed in a kitchen drawer and were locked and inaccessible to residents in care. LPA observed a Fire Extinguisher on the kitchen wall and was last purchased on 11/03/2025. MEDICATION ROOM: The centrally stored medication are observed in the kitchen cabinet and were locked and inaccessible to residents in care. LPA observed medications in two (2) residents rooms unlocked and accessible to residents in care. Additionally, LPA observed staff medication accessible in the kitchen in a separate cabinet. Moreover, LPA observed staff and residents medications unlocked and accessible in the facility's fridge. During review of R3's random medication revealed that the facility was supposed to start Januvia 100 MG (Diabetes Medication) a new bottle on 10/08/2025. Continue on LIC 809C During today's visit LPA counted R3's medication and it was discovered that there was a discrepancy and five (5) extra pills were in the bottle. LPA asked the Administrator and the staff for explaining and both staff and the Administrator could not provide any answers. BEDROOMS: There are four (4) bedrooms designated for resident’s use. LPA observed that all bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. Auditory alarms were tested and observed to be operational. BATHROOMS: LPA observed that the facility has two (2) bathrooms. LPA observed all bathrooms are clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed appropriate grab bar and had non-skid mat. The water temperature was noted at 111.6°. LAUNDRY ROOM: The laundry room is located by the kitchen in a closet where all cleaning supplies and laundry detergents are kept. LPA observed that the laundry room was locked and inaccessible to residents in care. All cleaning supplies and laundry detergents are kept in the laundry closet. The washer/dryer appear to be in good working condition. COMMON AREAS: The facility maintains a comfortable temperature at 71°F. The living room and dining area appeared clean and were properly furnished and has a television. No obstructions and or tripping hazards throughout the facility. LPA observed a working telephone for the facility. SURROUNDING GROUNDS: The facility has sufficient front yard space. LPA did observe appropriate outdoor furniture in the backyard of the facility that can accommodate six (6) residents, LPA observe a covered shaded area for residents with some games for outdoor activities. There is no swimming pool or any bodies of water at the facility. LPA observed one emergency exit and it was observed free of any obstruction or hazard. Garage/Storage: The facility does not have any extra garage/storage space. Continue on LIC 809C SMOKE DETECTORS/CARBON MONOXIDE. Smoke detectors and carbon monoxide were located throughout the facility. At 1:00 PM, they were tested and observed to be operational. Between 12:00 PM to 2:45 PM, LPA reviewed records of five (5) residents and one (1) staff. Two (2) out of five (5) residents did not have TB test results. S1 did not have any of the required training on file. During the visit, LPA observed two staff working providing care and supervision to residents in care; however, both staff (S1 and S2) were not fingerprint cleared and associated to the facility. S2 hire date was 09/24/2025, and S2 only worked at the facility for four (4) days since hire date. Administrative: LPA collected Certificate of Liability Insurance, and LIC500. Deficiencies issued on LIC 809D. Exit interview conducted. Appeal rights explained and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Nov 3, 2025

Type of visit: Prelicensing

At 09:30 AM, Licensing Program Analyst (LPA), Huma Rahimi conducted an announced Pre-Licensing visit to the above facility and met with Gregor Greg Shamamyan, Licensee/Administrator, and explained the reason for the visit. At the time of this visit LPA did not observe any residents present in the facility. Fire Clearance dated 08/15/2024 and received for five (5) Non-ambulatory, and one (1) Bedridden (room #4) 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, Division 6. The facility is a single-story building. Today's site visit consisted of LPA touring the physical plant inside and outside and observed the following: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven, and a sink. Stove was observed in a good working condition. At 09:25am, LPA observed adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). All knives and sharps are observed to be locked in a kitchen cabinet and inaccessible to residents. LPA observed two Fire Extinguishers and were last purchased on 06/08/2024. They were observed hanging on the wall in the kitchen. MEDICATION ROOM: The centrally stored medication will be kept in the in the locked kitchen cabinet. Residents and staff files will be kept locked in the living room inaccessible to residents. BEDROOMS: There are four (4) bedrooms designated for resident’s use. Bedrooms number one (1) and three (3) are shared. Bedroom (4) is used for a bedridden resident and bedroom (2) is private. All bedrooms are furnished with beds, dressers 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 LIC 809C BATHROOMS: There are two (2) bathrooms at the facility. Bathroom # (1) is in the living room and bathroom # (2) is by the bedroom # (4). LPA observed all bathrooms are clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed appropriate grab bar and had non-skid mat The water temperature was noted at 110.3°. LAUNDRY ROOM: The laundry room is located by the kitchen in a locked closet where all cleaning supplies and laundry detergents will be kept. All cleaning supplies and laundry detergents are kept inaccessible to residents in care. The washer/dryer appear to be in good working condition. COMMON AREAS: The facility maintains a comfortable temperature at 73°F. The living room and dining area appeared clean and were properly furnished and has a television. No obstructions and or tripping hazards throughout the facility. LPA observed a working telephone for the facility. SURROUNDING GROUNDS: The facility has sufficient front yard space. LPA did observe appropriate outdoor furniture in the backyard of the facility that can accommodate six (6) residents, LPA observe a covered shaded area for residents with some games for outdoor activities. There is no swimming pool or any bodies of water at the facility. The exit was free of any obstruction or hazard. Garage/Storage: The facility does not have any extra garage/storage space. SMOKE DETECTORS/CARBON MONOXIDE. Smoke detectors and carbon monoxide were located throughout the facility. At 9:55 AM, they were tested and observed to be operational. Component III was conducted with the Licensee/Administrator. Facility is in compliance with Title 22 Regulations at this time. This report will be forwarded to the Centralized Application Bureau (CAB) and 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 the Applicant/Administrator.the state’s words, verbatim · CDSS document, Oct 24, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): N/A COMP II Participants: licensee/administrator Grigor Shamamyan Interview Method: Telephone interview On 10/4/2024, 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 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, Oct 4, 2024