S&K Care Center

Type of visit: Prelicensing

At 10:00a.m., Licensing Program Analyst (LPA), Antonia Alvizar-Ettima conducted an announced Pre - Licensing visit to the above facility and met with Assistant Administrator/CEO. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL).Fire Clearance was approved on 12/04/25 for a maximum capacity of six (6) non – ambulatory residence age range 60 and over. The purpose of today’s visit is to inspect the facility to ensure that the physical plant is in compliance with rules and regulations of California Code of Regulations, Title 22, Division 6, Chapter 8. The facility is a single-story building in a residential community. The facility has two (2) fully charged fire extinguishers, located in the entrance and dining area. Fire extinguishers receipt dated June 16, 26. Emergency exit plan/sketch is posted on the entrance wall along with other posting requirements. Additional emergency exit plan/sketch are posted in each bedroom. Telephone (818) 210-0066 land line is operable. LPA utilized Compliance and Regulatory Enforcement (CARE) tools. A tour of the physical plant inside an outside was initiated at approximately 10:50a.m., and the following was observed: KITCHEN: The facility has a kitchen area that is equipped with a sink, stove, microwave, dishwasher and two (2) refrigerators. The kitchen food preparation was observed to be sanitary. No perishable food currently however, a supply of nonperishable and emergency food in kitchen cabinets. There was dinnerware present to accommodate a maximum capacity of six (6) residents. All knives and sharps are observed to be locked in a drawer in the kitchen and inaccessible to residents. Cont. on LIC809-C Cont. from LIC 809 BEDROOMS: There are three (3) shared bedrooms. All residents’ bedrooms are furnished with bed, chair, nightstand, dresser and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. BATHROOMS: LPA inspected the bathrooms they are clean and in excellent condition. LPA observed two (2) full bathrooms with grab bars and non-skid mats for residents and staff to use. Water temperature was within regulation ranging between 110.9°F – 111.4°F. LPA also observed sufficient quantity of toilet papers, soap and paper towels. COMMON AREAS: The facility maintains a comfortable temperature at 76°F. The living room has a television, couches, magazines, coloring books and board games. The dining area has a table with six (6) chairs that were clean and properly furnished. OFFICE SPACE: The medication and first aid kit will be stored in a locked cabinet inaccessible to residents. Staff and residents’ records will be maintained in a locked metal filing cabinet inaccessible to residents. LAUNDRY SPACE: The laundry space is located next to kitchen; the washer and dryer were in working condition at the time of the visit. Laundry detergents and cleaning supplies were observed stored in the laundry space inaccessible to residents. SMOKE DETECTORS/CARBON MONOXIDE. Dual smoke detectors and carbon monoxide were located in the bedrooms and throughout the facility. They were tested and observed to be operational EMERGENCY LIGHT: Emergency lighting was observed installed and operational in the facility in each room and throughout the facility. SURROUNDING GROUNDS: The facility grounds were well maintained and enclosed. The passageways and entrance to the facility were clear of obstruction. Entry and exit doors have a functional auditory alert when the doors open at the time of visit. LPA observed appropriate outdoor furniture and sufficient shaded yard area for residents. LPA discussed the importance of maintaining care and supervision to meet the needs of residents. The facility has no garage or body of water. Component III: Assist Administrator/CEO, Knarik Horsepyan completed Component III during today’s pre-licensing visit and acknowledged understanding. Based on inspection and observation, the physical plant is in compliance with Title 22 Regulations at this time. This report will be forwarded to the Centralized Application Bureau (CAB), and the applicant will be notified by the CAB Analyst when your license has been approved. Exit interview was conducted and a copy of this report was provided to Assistant Administrator/CEO.the state’s words, verbatim · CDSS document, Jun 17, 2026

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INITIAL Capacity: 06 Census : 0 Method: Telephone call with CAB COMP II Participants: ZHENYA GHEVONDYAN; KNARIK HOVSEPYAN Administrator/Licensee participated in COMP II via telephone call with CAB analyst. Identification of the Administrator/Licensee was verified by confirming driver’s license number. During COMP II, Administrator/Licensee confirmed the understanding of Title 22. Component II was successfully completed. Administrator/Licensee was advised to email signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Administrator/Licensee'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, Jun 12, 2026