New Millennium RCFE

Type of visit: Required - 1 Year

On 6/5/2026 at approximately 12:20pm, Licensing Program Analyst (LPA), Perchui Milena Khurshudyan conducted an unannounced annual visit to the facility. LPA was greeted by the caregiver and stated the reason for their visit. The Administrator Assistant, Rebeka Durgaryan arrived shortly after to assist with today’s visit. LPA asked for the census, Staff/Resident Roster, and Liability Insurance. LPA conducted a physical plant tour at approximately 12:40 PM and the following was noted: The facility is a single-story building with four (4) bedrooms, three (3) bathrooms. The facility is currently occupying four (4) residents. There is designated staff room. The facility has an approved fire clearance for six (6) non-ambulatory residents of which one (1) may be bedridden for bedroom #4. Hospice waiver approved for four (4). Common areas: The living room and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 76°F. LPA observed two (2) fire extinguishers located throughout the facility and dated 3/15/2026. LPA observed required postings such as Long-Term Care Ombudsman, Emergency Disaster Plan, and Personal Rights alongside the entrance leading towards the kitchen. A working telephone was observed. Kitchen: The kitchen was observed to be clean and free from pests. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. Knives/sharps were observed to be kept in a locked box, inside the kitchen cabinet. The cleaning solutions/toxins were observed to be kept under the sink, inside a locked cabinet. Kitchen appliances were observed to be working and in proper condition. Continued on LIC 809-C Bedrooms: The residents’ rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are lighted appropriately. Extra linens/covers were observed readily available. Bathrooms: The bathrooms were checked for cleanliness and proper operation. The hot water temperature was measured within regulations at 118.2 °F. LPA observed appropriate grab rails and slip-resistant mats to be in proper condition. Laundry Room: The laundry room was observed to be located under the patio. LPA observed cleaning solutions and toxins stored inside the locked cabinets. The laundry appliances were observed to be working and in proper condition. Garage: LPA observed garage is used as a storage. Backyard: The backyard of the facility is equipped with a designated shaded area with outdoor furniture for residents. There is a pool in the property with proper locked gates. Medications: The medications were observed stored in a locked closet located in the hallway. LPA reviewed the Centrally Stored Medication and Destruction Records and found documentation to be complete and accurate. All PRN medications had current physician orders. LPA observed staff and resident files to be kept locked in storage cabinet located inside the closet. First-aid kit observed to be equipped with but not limited to bandages, scissors, digital thermometer, tweezer and First-Aid Manuel. Smoke detectors and carbon monoxide observed to be working properly and were tested at 3:28pm. Residents/Staff Records: LPA conducted a complete file review of resident records. Resident records appeared to be complete and updated. Staff records: LPA conducted a complete file review of staff records. Staff records appeared to be complete and updated. There were no immediate health and safety hazards observed during the day of inspection. LPA collected LIC500, LIC9020, copy of Certificate of Liability Insurance, and copy of Administrator Certificate. LPA informed the Administrator/ Licensee to update LIC610E Emergency Disaster Form and submit the updated form to the department. No deficiency cited during today's visit. Exit interview was conducted and a copy of this report was provided to the Administrator.the state’s words, verbatim · CDSS document, Jun 5, 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, Chloe Moore, and explained to them the purpose of the visit. The administrator, Rebeka Durgaryan was notified, and came to the facility shortly after. At approximately 09:45am, LPA took a tour of the physical plant. The facility is a one story building. The smoke alarms and carbon monoxide detectors are dual, hardwired and interconnected. There are two fire extinguishers. One is located by the kitchen, and the other is in the hallway. Both fire extinguishers were purchased on 02/11/25. 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 lock box, high, in a kitchen cabinet. No cleaning supplies were observed during the inspection. Bedrooms: There are four (4) bedrooms, of which three (3) are designated for residents' use. One bedroom is designated for staff. The three resident rooms are shared. Resident bedrooms are properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are three (3) bathrooms in the facility. Two (2) are designated for residents' use, and one (1) is used for staff. The two bathrooms designated for the resident's use were properly supplied and had functional fixtures. Hot water temperature was measured at 109 degrees Fahrenheit. Bathrooms were clear of any cleaning supplies and toxins. Common Areas: These included the living room and dining area. The living room is furnished with a large U-shaped couch, table, entertainment center and television. There is a fireplace by the dining room that is non-functional and properly screened. No fire-place key or tools on site. The dining room table is large enough to seat six (6) residents. LPA observed the floors to be clean and furniture in good repair. Hallways and passageways were clear of obstruction. Garage: The garage is attached to the home. Garage is always kept locked by the property owner, and is not used by the facility. Laundry: The laundry area is located in the enclosed patio area. There is a sink next to the washer and dryer. Detergents and cleaning supplies were kept locked in one of the cabinets under the sink next to the washer and dryer. Surrounding Grounds: Entry/exits were free of obstruction. There is a enclosed patio area with additional furniture for the resident's to use. There is a storage area in the backyard, which was observed to be locked during the inspection. There is a swimming pool that is fenced all around with a gate that will be kept locked at all times. The fence surrounding the swimming pool is approximately 5 feet high all around its parameters. Staff Workstation/office: No staff office or workstation. Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files: LPA conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications: Medications are stored in a locked in a closet near the living room. Medications and medication records were reviewed for appropriate storage and proper 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 the Report Issued.the state’s words, verbatim · CDSS document, Apr 16, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Michael Cava conducted a Pre-Licensing Inspection with the applicant representative and administrator, Satenik Avagyan and Rebeka Durgaryan. An Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on July 1, 2022. A fire clearance was approved on June 14, 2023 for a total capacity of six. The smoke alarms and carbon monoxide detector are dual, hard wired and inter-connected. The facility has two new fire extinguishers that was purchased on October 5, 2023. One fire extinguisher is located in dining room/kitchen area, and the other at the hallway. A tour of the physical plant was initiated at approximately 1:15pm and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. The Because the facility is brand new, with zero (0) residents, a supply of perishable food not required at this time. LPA did observe an adequate supply of nonperishable food stored in one of the kitchen cabinets. BEDROOMS: There are four (4) bedrooms designated for client use. Bedroom #1 and #2 are designated for private use. Bedroom #3 and #4 will be shared rooms. The applicant furnished the resident bedrooms with beds, night stand, chairs, dresser, bedding and linen (shared bedrooms had two of each). All bedrooms have sufficient lighting and closet space. BATHROOMS: The facility has three (3) bathrooms. Two bathrooms are designated for resident use, and one for staff. Bedroom #1 has it's own bathroom. The bathrooms, designated for resident use were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured at 120 degrees at the time of the visit. COMMON AREAS: These included the living room, dining room and patio areas. Rooms were equipped with living room furniture, a television, tables and chairs. There is a fireplace with a screen slide in the dining area. It is non-operational, with the key stored and inaccessible to residents. Also, there was no tools for the fireplace accessible or in the open at the time of the visit. The dining area has a large dining room table to accommodate six (6). There were no visible immediate hazards. LAUNDRY Area: The laundry area is located in the enclosed patio area. There is a sink next to the washer and dryer. No cleaning supplies will be maintained there. MEDICATIONS: Medications and medication records will be kept locked in the hallway closet. Staff/Resident files: Staff and resident files will be maintained in the same closet where medications will be kept. SURROUNDING GROUNDS: The driveway, 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 backyard of the facility has an enclosed patio area with furniture to accommodate the six (6) residents. There is a storage space, which one side will be locked at all times, and another side of the storage space, has no lock, but applicant is advised not to maintain any sharps or hazardous items in. There is a swimming pool that is fenced all around with a gate that will be kept locked at all times. The fence surrounding the swimming pool is approximately 5 feet high all around its parameters. In addition to the Pre-Licensing inspection, a Component III power point presentation was also held. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised and a copy of this report provided.the state’s words, verbatim · CDSS document, Mar 1, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Interview Method: Telephone interview On 2/6/2024, 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, Feb 6, 2024