Skyhill Quality Living #2

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced Required - 1 Year annual inspection visit. Upon arrival LPA was greeted by Elmer Manalang and explained the purpose of the visit. Administrator Tina Arutyunyan arrived around 11:05am. Residential Care Facility for Elderly (RCFE) is licensed for six (06) non-ambulatory residents ages 60 and above. Facility has a hospice waiver for four (04) and is approved for two (2) bedridden residents, to occupy bedroom#1. Current census is three (3) residents, two (2) of them are non-ambulatory. LPA toured the facility with the Administrator at 10:50 am and observed the following: Required postings were observed by the entry door and office area. The house is one-story, in a residential neighborhood and the physical plant appeared clean, sanitary and with no visible immediate hazards. The front entry is the main emergency door with four (4) additional exits (the kitchen, bedrooms #1, #2, and #3) leading to the backyard. There is one (1) fire extinguisher in the kitchen, purchased on 09/24/2025. Facility conducts quarterly fire and safety drills; the last fire/earthquake drill was conducted on 02/05/2026. The dual smoke alarms and carbon monoxide detectors are battery operated. Smoke/carbon monoxide detectors were tested in several rooms and were observed to be functional. Facility is equipped with fire sprinklers in every room and also facility has land-line telephone, cable, internet for resident's use. Common Areas: Living room is located upon entrance and is furnished with a table and ample sitting for all the residents and staff. There is a television and gaming area in the living room. The office area is located in one corner of the living room. Dining area is located in the kitchen, furnished with a table and six chairs. Continued on 809-C Kitchen: There are two (2) refrigerators, stove and a microwave in the kitchen with a dining table/chairs for six clients. Knives, cutlery and other sharp kitchen utensils are stored and locked in the kitchen drawer. Chemicals, soaps and laundry detergents are kept in a locked cabinet. Food storage and preparation areas are clean and sanitary. LPA found a sufficient amount of perishable food supplies for two (2) days and non-perishable food supplies for seven (7) days in the kitchen. Bathrooms: There are two (2) full bathrooms for the residents' use. One of the bathrooms is located between room#3 and #4. The other bathroom is shared bathroom between room#1 and #2. All toilets and sinks are maintained in sanitary, operating condition. Functional grab bars and non-slip mats were observed in resident bathrooms. Hot water temperature was tested between 109.9 - 111.7 degrees Fahrenheit. Bedrooms: There are four (4) bedrooms for resident use. Bedrooms #1 is a shared room, approved for 2 bedridden residents but currently is used as a private room. Bedroom #2 is currently vacant. Bedroom #3 and #4 are shared rooms, but currently are being used as private room. Bedrooms #1, #2 and #3 have exit doors, leading to the backyard. All of the bedrooms were properly furnisshed with appropriate chairs, beddings, chest drawers, linens with sufficient lighting. LPA observed call buttons in each bedroom. While preparing the report at approximately 9:59am, resident in room#4 pushed the call button and staff responded to call button within less than a minute. Surrounding grounds: Entry/exit gates and pathways were free of obstruction. The outdoor area was free of visible immediate hazards. No bodies of water were observed at the facility. There is a shaded patio area in the front yard, with furniture appropriate for outdoor use, sufficient for number of clients. Facility has a detached garage with a bathroom which currently is used for live-in staff but facility has an awake staff at nights. Laundry machines were located in the backyard but all detergents/chemicals are stored in a locked cabinet in the kitchen. Medications: The medication are centrally stored and locked in a kitchen cabinet. LPA observed a complete first-aid kit in the office area, with all required supplies and the first aid manual. Medication records for two (2) residents were reviewed and medications were counted for accuracy of administration based on physician orders. Continued on 809-C Resident/Staff Files: LPA reviewed records for all three (3) residents to ensure compliance of licensing forms. Records for four (4) staff were reviewed to ensure all forms, and trainings and First Aid/CPR certificates are up to date. Administrative documents: Administrator Certificate Expiration date is 04/05/2027. LPA reviewed and obtained copy of Emergency and Disaster Plan for RCFE LIC610E. Liability insurance was also reviewed with expiration date of 03/06/2027. Pursuant to Title 22 Division 6 of the CA Code of Regulations no deficiencies were observed during the visit. Exit Interview Conducted / A Copy of the Report provided to Administrator.the state’s words, verbatim · CDSS document, Mar 24, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced Required - 1 Year annual inspection visit. Upon arrival at 8:30am, LPA met with Tina Arutyunyan-Administrator and explained the purpose of the visit. Facility is licensed for six (06) non-ambulatory residents with a hospice waiver for four (04). Current census is three (3) residents, two (2) of them are non-ambulatory. LPA toured the facility with the Administrator at 10:10 am and observed the following: Required postings were observed by the living room and office areas. The front entry is the main exit door with four (4) additional exits (the kitchen, bedrooms #1, 2, and 3) leading to the backyard. The physical plant appeared clean, sanitary and with no visible immediate hazards. There are two (2) fire extinguishers, one (1) in the kitchen, one (1) in the office/living room. Both fire extinguishers were fully charged on 01/23/2025. Facility conducts quarterly fire and safety drills; the last fire drill was conducted on 02/052025. The dual smoke alarms and carbon monoxide detectors are hardwired and interconnected, in addition facility is equipped with fire sprinklers in every room. Smoke/carbon monoxide alarms are tested by the Burbank Fire Department annually, the last inspection was on 01/23/2025. Continued on 809-C Common Areas: Include a living room with television and gaming area, dining area in the kitchen. The office area is located near the living room. The living room had a table and ample sitting for all the residents and staff. Kitchen: There are two (2) refrigerators, stove, macro wave, dishwasher in the kitchen with a dining table/chairs for six clients. Knives, cutlery and other sharp kitchen utensils are stored and locked in the kitchen cabinet. Food storage and preparation areas are clean and sanitary. LPA found a sufficient amount of perishable food supplies for two (2) days and non-perishable food supplies for seven (7) days in the kitchen. Bathrooms: There are three (3) full bathrooms for the residents. All toilets and sinks are maintained in sanitary, operating condition. Functional grab bars and non-slip mats were observed in resident bathrooms. Hot water temperature was tested between 109 - 110.3 degrees Fahrenheit. Bedrooms: There are four (4) bedrooms for resident use. Bedrooms #1 and #2 are private with their own bathroom and exit doors. Bedroom #3 has an exit door and bedroom# 4 has its own bathroom and exit door. All of the bedrooms were properly furnished with appropriate chairs, beddings, chest drawers, linens with sufficient lighting. LPA observed call buttons in each bedroom. LPA pushed the call button in rooms #3 and #4 and staff responded to call buttons within two (2) minutes. Surrounding grounds: Entry/exit gates and pathways were free of obstruction. The outdoor area was free of visible immediate hazards. No bodies of water were observed at the facility. There is a shaded patio area in the front yard, with furniture appropriate for outdoor use, sufficient for all clients. Facility has a detached garage with a bathroom which currently is used for staff use only. Laundry machines were located in the backyard and were recently purchased a month ago. All laundry detergents/chemicals are stored in a cabinet in the laundry area. LPA observed the cabinet for the chemicals to be unlocked. A citation will be issued for health and safety issue. Continued on 809-C Medications: The medication are centrally stored and locked in the kitchen cabinet. LPA observed a complete first-aid kit in the office area, with all required supplies and the first aid manual. Medication records for three (3) residents were reviewed and counted for accuracy of administration based on physician orders. LPA observed several supplements and medications for the staff, in an unlocked kitchen drawer. A citation will be issued for health and safety issue. Resident Files: A review of resident records to ensure compliance of licensing forms was conducted. Staff Files: Staff files were reviewed to ensure all forms and training certificates are up to date. Pursuant to Title 22 Division 6 of the CA Code of Regulations deficiencies were observed during the visit and citations were issued with appeal rights. Staff immediately corrected the deficiencies; Administrator will ensure that staff are retrained and will submit proof of correction to LPA. Exit Interview Conducted / A Copy of the Report provided to Administrator.the state’s words, verbatim · CDSS document, Mar 19, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abeye Duguma met with Elmer Manalang for a Required One (01) Year visit. Administrator, Tina Arutyunyan, designated Elmer Manalang as the person to sign and accept this report. LPA explained the reason for the visit. A tour of the physical plant was conducted at 1:10 PM and the following was noted: There is one entrance being utilized at the facility. The facility has a total of four (04) bedrooms for residents and three (03) bathrooms. The facility is fire cleared for six (06) non-ambulatory. The facility is currently occupying four (04) residents. The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. The garage is currently being used for storage and rest area for staff. Laundry detergents, cleaning agents and other toxins are locked away. Kitchen is sufficiently stocked with at least two (02) days perishable and seven (07) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents. The living and dining room are neat and clean. The facility maintains a comfortable temperature at 74°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located in the kitchen and office area, observed to be fully charged. (continued on LIC 809-C) The residents' rooms are adequately furnished with appropriate lighting system. Hallways are well lit. Residents have enough personal hygiene product provided by the licensee. The bathroom was checked for cleanliness and proper operations. The hot water temperature was measured at 114.7°F. Towels and washcloths are not shared. There was enough clean linen available in the cabinets. LPA observed medication and first aid kit to be locked and inaccessible to residents. No health and safety hazards noted during the visit. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Mar 9, 2024