Northridge Boarding Care

We haven’t transcribed this report yet. The complete document is on the state’s site.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mariana Agban conducted an announced annual required visit and inspection of the facility. LPA met Administrator Anna Adamyan and staff Arsen Boshyan. At approximately 09:45 am, with the assistance of the Administrator, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms and carbon monoxide detectors were tested, and they were functioning properly. The fire extinguisher is located in the kitchen and appears to be full. LPA observed the kitchen to be clean, and the kitchen appliances are functional. Knives were stored in a locked drawer in the kitchen. Bedrooms: There were four (4) bedrooms designated for residents' use. All bedrooms were furnished with appropriate bedding and linens, and had sufficient lighting. Bathrooms: There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 106.4 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. Common Areas: These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. The dining room table is large enough to seat the capacity of the facility. Seating such as couches where in good repair and sat the capacity of the facility. Surrounding Grounds: Entry/exits were free of obstruction. LPA observed the garage to be used as storage. Staff Files: LPA conducted a file review of records to ensure forms and training are up to date and in compliance with licensing forms.Resident Files: The facility census is 0. There were no resident files to inspect.Temperature: The Facility maintains a comfortable temperature of 73 degrees Fahrenheit 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, Aug 4, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Mariana Agban conducted a Pre-Licensing Inspection with facility Administrator Rena Danileyan and Lincensee Anna Adamyan. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on October 30, 2023. A fire clearance was approved on Jan 29, 2024 for a maximum capacity of five (5) non-ambulatory adults and one(1) Bedridden. Hospice waiver has been requested for six (6) residents which is pending approval of Manager. A tour of the physical plant was initiated at 9:20 am and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6) residents. BEDROOMS: There are four (4) bedrooms designated for residents use. Two bedrooms will be designated for shared rooms and the other two bedrooms are private. All bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space. Each bedroom had wearable lanyard emergency/ caregiver call button. LPA observed that the facility sketch indicated that Bedroom 1 and 4 are shared and Bedroom 2 and 3 are private. LPA advised licensee to update the facility sketch and email it to LPA. BATHROOMS: The facility has one (1) main bathroom and one (1) in the private bedroom number #3 for the resident in that room to utilize. Hot water temperature was not with range of 105 to 120. The Licensee stated that a representative from the gas company will fix the issue tomorrow 06/01/24. Common Areas: These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. Laundry Area: The laundry room is located in the kitchen. The washer/dryer appear to be in good condition. Laundry supplies are kept inaccessible in the garage. MEDICATION: The medication will be kept in a locked cabinet located in living area. Surrounding Grounds: Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. LPA observed and inspected the detached garage. No hazards observed. Garage is used for storage only. Pre-Licensing is incomplete with deficiencies to be resolved byJune 7, 2024. A follow up Pre-licensure LIC809 will be generated upon resolution of deficienciesCAB will be advised and a copy of this report provided.the state’s words, verbatim · CDSS document, May 31, 2024

Type of visit: Office

COMP II by CAB successfully completed Method: Phone Call at CAB Census (if any clients in care): Applicant/administrator participated in COMP II at CAB telephone call with analyst at CAB. Identification of the applicant and administrator was verified by presenting photo ID via phone. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, Apr 4, 2024