Rg Boarding Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jose Tan, met with House Manager Rafik Gevorgyan for a One (1) Year Required visit for this facility. LPA explained the reason for the visit. A tour of the physical plant was conducted at 1:18 PM and the following was noted: There is only one entrance being utilized at the facility. The facility had submitted and approved Infection Control and Mitigation plan. The facility has a designated visitors' area at the backyard. The facility has a total of four (4) bedrooms and three (3) bathrooms. One (1) of the bathroom is designated for staff use only. KITCHEN: The facility has a Kitchen that is equipped with a refrigerator, microwave, stove, dishwasher and sink. There was an adequate supply of perishable and nonperishable food. Knives were observed locked in a kitchen drawer. Cleaning supplies and other toxins are stored in the cabinet in the bedroom hallway which was locked during visit. BEDROOMS: There are four (4) bedrooms designated for clients' use: two (2) shared and two (2) private. The residents' bedrooms are furnished with beds, night stand, chairs, dressers, bedding and linen and have sufficient lighting and storage. BATHROOMS: The facility has two (2) shared bathrooms for clients' use. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water temperature was measured at a range of 117.8°F to 119.2°F. (continued on LIC 809-C) (continued from LIC 809) LAUNDRY ROOM: The laundry room is located in the bedroom hallway. Laundry detergents and other cleaning agents were locked in a cabinet along the bedroom hallway by the fire door. The cleaning supply cabinet was observed to be locked during visit. COMMON AREAS: These included the living room and the dining area. Living room was furnished with chairs and side tables. The living room area was furnished with a television, a coffee table and sofas to sit the capacity of the facility. There were no visible immediate hazards. Dual smoke/carbon monoxide alarms were tested and observed to be operable. Fire extinguisher was last bought on 07/29/26 and located in the dining room area. The facility is equipped with closed circuit television system in the outside surroundings only. MEDICATIONS: The medication cabinet is located in the office adjacent to the living room and has a locking mechanism. A complete first aid kit is located in the kitchen. Resident Records: All residents record were reviewed and observed to be complete and updated. Staff records were also reviewed and observed to be complete and updated. 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 a covered patio and backyard furniture to accommodate the residents. The Garage is converted into another resident room (room #4) and staff break room for staff where the refrigerators are also kept. There are two (2) tool shed on the side yard separated by a 5' gate and inaccessible to residents. There is a drive way in front of the facility which could park three (3) cars at a time. The swimming pool is appropriately fenced and was locked during visit. Disaster drill was last conducted on 07/21/26. Required posting observed in facility (complaint hot line poster). Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Aug 25, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jose Tan, met with administrator Hermine Karapetyan for a One (1) Year Required visit for this facility. LPA explained the reason for the visit. A tour of the physical plant was conducted at 9:08 AM and the following was noted: There is only one entrance being utilized at the facility. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Infection Control and Mitigation plan.The facility has a designated visitors' area at the backyard. The facility has a total of four (4) bedrooms and three (3) bathrooms. One (1) of the bathroom is designated for staff use only. KITCHEN: The facility has a Kitchen that is equipped with a refrigerator, microwave, stove, dishwasher and sink. There was an adequate supply of perishable and nonperishable food. Knives were observed locked in a kitchen drawer. Cleaning supplies and other toxins are stored in the cabinet in the bedroom hallway which was locked during visit. BEDROOMS: There are four (4) bedrooms designated for clients' use: two (2) shared and two (2) private. The residents' bedrooms are furnished with beds, night stand, chairs, dressers, bedding and linen and have sufficient lighting and storage. BATHROOMS: The facility has two (2) shared bathrooms for clients' use. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water temperature was measured at a range of 111.2°F to 116.8°F. (continued on LIC 809-C) (continued from LIC 809) LAUNDRY ROOM: The laundry room is located in the bedroom hallway. Laundry detergents and other cleaning agents were locked in a cabinet along the bedroom hallway by the fire door. The cleaning supply cabinet was observed to be locked during visit. COMMON AREAS: These included the living room and the dining area. Living room was furnished with chairs and side tables. The living room area was furnished with a television, a coffee table and sofas to sit the capacity of the facility. There were no visible immediate hazards. Dual smoke/carbon monoxide alarms were tested and observed to be operable. Fire extinguisher was last bought on 04/28/24 and located in the dining room area. The facility is equipped with closed circuit television system in the outside surroundings only. MEDICATIONS: The medication cabinet is located in the office adjacent to the living room and has a locking mechanism. A complete first aid kit is located in the kitchen. Resident Records: All residents record were reviewed and observed to be complete and updated. Staff records were also reviewed and observed to be complete and updated. 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 a covered patio and backyard furniture to accommodate the residents. The Garage is converted into another resident room (room #4) and staff break room for staff where the refrigerators are also kept. There are two (2) tool shed on the side yard separated by a 5' gate and inaccessible to residents. There is a drive way in front of the facility which could park three (3) cars at a time. The swimming pool is appropriately fenced and was locked during visit. Disaster drill was last conducted on 05/29/25. Required posting observed in facility (complaint hot line poster). Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Aug 13, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Gary Tan conducted a Pre-Licensing Inspection with the applicant representative Sahak Hovsepyan. The applicant is "RG Boarding Care Inc". A fire clearance was approved on 06/10/24 for six (5) non-ambulatory residents, one (1) of which may be bedridden on Room #2 and one (1) is approved for ambulatory resident only on Room#4. The applicant has an approved hospice waiver for six (6) residents. The facility has a total of four (4) bedrooms and three (3) bathrooms. One (1) of the bathroom is designated for staff use only. A tour of the physical plant was initiated at approximately 9:32 AM and the following was observed: KITCHEN: The facility has a Kitchen that is equipped with a refrigerator, microwave, stove, dishwasher and sink. There was an adequate supply of perishable and nonperishable food. Knives were observed locked in a kitchen drawer. Cleaning supplies and other toxins will be stored in the cabinet in the bedroom hallway which was locked during visit. BEDROOMS: There are four (4) bedrooms designated for clients' use: two (2) shared and two (2) private. The applicant furnished the residents' bedrooms with beds, night stand, chairs, dressers, bedding and linen. The bedrooms have sufficient lighting and storage. BATHROOMS: The facility has two (2) shared bathrooms for clients' use. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water temperature was measured at a range of 109.7°F to 111.0°F. LAUNDRY ROOM: The laundry room is located in the bedroom hallway. Laundry detergents and other cleaning agents were locked in a cabinet along the bedroom hallway by the fire door. The cleaning supply cabinet was observed to be locked during visit. (continued on LIC 809-C) (continued from LIC 809) COMMON AREAS: These included the living room and the dining area. Living room was furnished with chairs and side tables. The living room area was furnished with a television, a coffee table and sofas to sit the capacity of the facility. There were no visible immediate hazards. There is a working telephone line and internet accessible to residents. Dual smoke/carbon monoxide alarms were tested and observed to be operable. Fire extinguisher was last bought on 04/28/24 and located in the dining room area. The facility is equipped with closed circuit television system in the outside surrounding only. MEDICATIONS: The medication cabinet is located in the office adjacent to the living room and has a locking mechanism. A complete first aid kit is located in the kitchen. Staff/Resident Records: Staff and resident records will be kept in the filing cabinet beside the office together with the medication. 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 a covered patio and backyard furniture to accommodate the residents. The Garage is converted into another resident room (room #4) and staff break room for staff where the refrigerators are also kept. There are two (2) tool shed on the side yard separated by a 5' gate and inaccessible to residents. There are drive way in front of the facility which could park three (3) cars at a time. The swimming pool is appropriately fenced and has a locking mechanism. Component III was conducted with the Licensee representatives. This report will be sent to Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when the 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 conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Aug 2, 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 - Hermine Karapetyan CEO/ Sahak Hovsepian Administrator Interview Method: Telephone interview On July 19, 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 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, Jul 19, 2024