Loving Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sandra Urena arrived unannounced at the facility to conduct the required annual inspection. The LPA was greeted by staff and informed them of the reason for the visit. Administrator Edith Mardorossians arrived shortly thereafter. The LPA, and the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. COMMON AREAS: At the time of the visit, living room and dining room furniture were observed to be in good condition. The facility maintained a comfortable temperature. Smoke detector(s) and carbon monoxide detectors were tested and operational at the time of the visit. The fire extinguisher was fully charged and was last purchased on 05/25/2025. The LPA observed required postings throughout the common space. LAUNDRY ROOM: Washer and dryer are located in the hallway. Detergents and cleaning supplies will be stored in locked cabinet next to the washer and dryer. KITCHEN: Kitchen knives are stored locked and inaccessible in a kitchen drawer. A seven-day supply of non-perishable food was available. The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen cleaning supplies will be stored and locked in a cabinet next to the washer and dryer. Hot water temperature was recorded at 118.5 degrees Fahrenheit. Trash cans have a tight-fitting lid. There were no pesticides or toxins stored near food, or preparation area. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. Continues on LIC 809C... BEDROOMS: All bedrooms were supplied with all required bedding and linens. There is sufficient lighting as well as closet and drawer space available. BATHROOMS: There are (2) full bathrooms. Bathrooms are equipped with toilet and shower grab bars. There are sufficient supplies of towels, paper goods and personal hygiene supplies. Hot water delivered at 115.5 degrees Fahrenheit. SURROUNDING GROUNDS: The exterior passageways were clean and clear of any obstructions. The patio is furnished with outdoor furniture for residents’ use, and shade is available. The building has a central entrance for residents and visitors. Fire emergency gates are clear of obstructions. No bodies of water were noted. RECORDS: Records review began at 01:25 p.m. Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. MEDICATIONS: Medications review began at 2:15 p.m.; medications are centrally stored and locked in a cabinet in the kitchen area; medications are labeled and checked for expiration dates. The medications are documented properly on the centrally stored medications and destruction record. No errors observed during the medication review. The LPA reviewed the following documents: - LIC500 Personnel Report - LIC9020 Client Roster - Certificate of Liability of Insurance _ Emergency Drill Logs No citations were issued. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Sep 23, 2025

Type of visit: Prelicensing

On 10/02/2024, Licensing Program Analyst (LPA), Sandra Urena conducted a subsequent pre-licensing visit. The LPA arrived at the facility at 09:30 a.m. and met with Applicant Edith Mardorossians. This is a new facility application for a Residential Facility or the Elderly (RCFE). On 09/2024, the initial pre-licensing visit was conducted by Licensing Program Analyst (LPA), Sandra Urena. The LPA arrived at the facility and met with Applicant Edith Mardorossians. The LPA, and the applicant toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. This is a new facility application for a Residential Facility or the Elderly (RCFE) four (4) non-ambulatory residents, which one can be a bedridden resident. Fire Clearance was approved on 12/14/2023 for one bedridden resident in bedroom #2. A hospice waiver was granted for four (4) residents. At 09:45 a.m., the LPA and the Applicant toured the facility to ensure the corrections were completed. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview was conducted and reviewed with applicant. A copy of the report was issued.the state’s words, verbatim · CDSS document, Oct 2, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Sandra Urena conducted a Pre-licensing visit at 10:30 a.m. and met with the Applicant Edith Mardorossians. This is a new facility application for a Residential Facility or the Elderly (RCFE) four (4) non-ambulatory residents, which one can be a bedridden resident. Fire Clearance was approved on 12/14/2023 for one bedridden resident in bedroom #2. A hospice waiver was granted for four (4) residents. At 10:35 a.m., the LPA, and the applicant toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN: Kitchen knives are stored locked and inaccessible in a kitchen drawer. A seven-day supply of non-perishable food was available. The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen cleaning supplies will be stored and locked in a cabinet next to the washer and dryer. Hot water temperature was recorded at 117.5 degrees Fahrenheit. Trash cans have a tight-fitting lid. There were no pesticides or toxins stored near food, or preparation area. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. A fire extinguisher is located next to the refrigerator exit, which was purchased on 03/01/2024. BEDROOMS: There are (3) bedrooms for residents in care. Room 1 is a private room, bedroom #2 is a shared room with two beds, and bedroom #3 is a private room. One bed in bedroom #2, has half-bed rails, which need to be removed. Bedroom #2 has two collapsible closets, one for each resident as the room does not have a stationary/permanent closet. One collapsible closet sits next to five-drawer chest, which prevents easy access to the five-drawer chest. Room #3 was approved by the fire department as the bedridden bedroom. All other bedrooms are cleared for non-ambulatory. All bedrooms were supplied with all required bedding and linens. There is sufficient lighting as well as closet and drawer space available. BATHROOMS: There are (2) full bathrooms. Bathrooms are equipped with toilet and shower grab bars. There are sufficient supplies of towels, paper goods and personal hygiene supplies. Hot water delivered at 115.5 degrees Fahrenheit. Continues on LIC 809C... COMMON AREAS: These include a living space equipped with a television. There is a dedicated area for the posting of required documents. Smoke and carbon monoxide alarms were tested and functional at the time of the visit. Medication, resident and staff files are stored and locked in cabinet in two separate cabinets in the kitchen area. LAUNDRY ROOM: Washer and dryer are located in the hallway. Detergents and cleaning supplies will be stored in locked cabinet next to the washer and dryer. SURROUNDING GROUNDS: The exterior passageways were clean and clear of any obstructions. The patio is furnished with outdoor furniture for residents’ use, and shade is available. The building has a central entrance for residents and visitors. Fire emergency gates are clear of obstructions. Walkways behind the property and next to the front door, will have to be fenced to prevent residents wondering into these uneven ground areas. Facility address (numbers) need to be relocated to the proper building/door, so that the address numbers reelect the actual building. The following corrections will need to be completed prior to approving licensure. Corrections will be completed by: Friday, September 27,2024. Fence will added to separate front licensed facility(Loving Care Inc), from Loving Home Inc. to include an entrance gate. Facility address (numbers) need to be relocated to the proper building/door, so that the address numbers reelect the actual building. · Bedroom #2 has two collapsible closets, one for each resident as the room does not have a stationary/permanent closet. One collapsible closet sits next to five drawer chest, which prevents easy access to the five drawer chest. · One bed in bedroom #2, needs to have half-bed rails removed. · Applicant will email a new sketch to Centralized Application Bureau (CAB), and Community Care Licensing (CCL) LPA to reflect the changes to the main entrance and exit path during an emergency and meeting points during an evacuation. · Walkways behind the property and next to the front door, will have to be fenced to prevent residents wondering into these uneven ground areas. At 1:35 p.m., the applicant completed Component III Orientation. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview was conducted and reviewed with applicant the applicant. A copy of the report was issued.the state’s words, verbatim · CDSS document, Sep 20, 2024

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Initial Capacity: 5 Census (if any clients in care): none COMP II Participants: Edith Madorossians, Applicant/Administrator Interview Method: Telephone interview On August 9, 2024 at 9:00AM, applicant/administrator participated in COMP II. Identification of the applicant/ administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant/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 Readiness Exit interview conducted with Administrator/Member. Report sent via email and request to return sign copy to CAB by end of business day.the state’s words, verbatim · CDSS document, Aug 9, 2024