Stars Board and Care Facility

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sandra Urena conducted an annual required visit to the above noted facility. The LPA was greeted by staff. Staff contacted facility representative Emma Kochinyan, who arrived thereafter. The LPA and the staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. LPA reviewed physical plant findings with facility representative once the representative arrived at the facility. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. There is a fireplace in the living room, which is screened and inaccessible. The facility maintained a comfortable temperature of 76 degrees. Smoke detectors and carbon monoxide detector were tested and operational at the time of the visit. There is a functioning telephone on the premises. The two (2) fire extinguishers were serviced on 3/31/2025. The LPA observed the required postings were posted by the dining room area. KITCHEN: Kitchen knives are stored inaccessible in a drawer to the right of the stove. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of non-perishable food is adequate. Appliances in the kitchen were clean and all appeared functional at the time of the visit. Trash cans had tight fitting lids. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. BEDROOMS: The facility has two (2) shared residents’ bedrooms, and one (1) private bedroom. All bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Continues on LIC 809C... BATHROOMS: There are two (2) bathrooms total. The resident bathroom(s) have a shower with non-skid materials. The toilet and shower have grab bars. The hot water temperature was tested in the bathrooms and the kitchen and was found to be within the range of 105*F and 120*F. OUTDOOR AREA: The backyard has a covered outdoor area equipped with furniture for client use. There is a side gate for client use and is single latched. The laundry room is located on the exterior of the house attached to the home. Cleaning supplies and toxins were observed stored and the room will be inaccessible to residents in care. The garage is located detached to the home, and the LPA observed supplies are stored in the garage. No bodies of water were observed. RECORDS: Records review began at 1:01 p.m., Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms, all files were in order. Personnel records were reviewed health assessments, criminal record clearances, first aid/CPR training, and the appropriate trainings. All files were fou d to be in order. MEDICATIONS: Medications review began at 1:50 p.m.; medications are centrally stored and locked in a cabinet in the kitchen area; medications are labeled and were checked for expiration dates. Medications were properly documented on the centrally stored medications and destruction record. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Nov 13, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sandra Urena conducted an annual required visit to the above noted facility. The LPA was greeted by staff. Staff contacted facility representative Emma Kochinyan, who arrived thereafter. The LPA and the staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. LPA reviewed physical plant findings with facility representative once the representative arrived at the facility. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. There is a fireplace in the living room, which is screened and inaccessible. The facility maintained a comfortable temperature of 76 degrees. Smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. There is a fireplace in the living room, it was observed to be screened. There is a functioning telephone on the premises. The two (2) fire extinguishers were observed to have been purchased on 02/20/2023 and were expired at the time of today’s inspection. The LPA observed that the required postings were missing, except for the Facility License. Missing postings: Ombudsman Poster, Community Care Licensing Poster, Personnel Schedule (LIC 500), Resident Roster (LIC 9020), Residents’ Rights, and Facility Floor Plan/sketch. KITCHEN: Kitchen knives are stored inaccessible in a drawer to the right of the stove.The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of nonperishable food is adequate. Appliances in the kitchen were clean and all appeared functional at the time of the visit. Trash cans had tight fitting lids. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. BEDROOMS: The facility has three (3) shared residents’ bedrooms. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Bedroom #1 had two residents at the time of the inspection. Continues on LIC 809C... BEDROOMS: Residents’ beds were observed to have full bed rails at the time of the inspection. Bedrooms’ number #2 and #3, were empty. Bedroom #2 was being used a staff’s bedroom at the time of the inspection. Facility representative stated that the night staff uses it for sleeping, since they haven’t had more than two residents since facility opened. The pre-licensing visit states that nocturnal (NOC), will be awake night staff only. There is no staff room designated in the facility sketch; consequently bedroom #2 cannot be used for staff use unless the facility licensee decides to make changes to the facility application. Facility representative has agreed to clean out the room. There was a linen closet in the hallway with extra towels and linens. BATHROOMS: There are two (2) bathrooms total. The resident bathroom(s) have a shower with non-skid materials. The toilet and shower have grab bars. The hot water temperature was tested in the bathrooms and the kitchen and was found to be within the range of 105*F and 120*F. OUTDOOR AREA: The backyard has a covered outdoor area equipped with furniture for client use. There is a side gate for client use and is single latched. The laundry room is located on the exterior of the house attached to the home. Cleaning supplies and toxins were observed stored and the room will be inaccessible to residents in care. The garage is located detached to the home, and the LPA observed supplies are stored in the garage. No bodies of water were observed. RECORDS: Records review began at 1:01 p.m., Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. One out of two residents’ files did not have updated required documentation. Personnel records were reviewed for, and were observed to be missing health assessments, criminal record clearances, first aid/CPR training, and the appropriate trainings. File for Administrator was not located at the facility. Two out of two staff files were missing: Health screenings/TB clearances, required 40-hour training, Criminal statement, Personnel Record, etc.MEDICATIONS: Medications review began at 1:50 p.m.; medications are centrally stored and locked in a cabinet in the kitchen area; medications are labeled and were checked for expiration dates. Medications were properly documented on the centrally stored medications and destruction record; for two out of two residents (Resident #1, Resident #2), the pill count was off during the medication audit. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties.Citations were issued. Exit interview conducted. A copy of the report was issued and Appeal Rights were issued.the state’s words, verbatim · CDSS document, Nov 7, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Brian Balisi conducted a pre-licensing visit to the above noted facility. The LPA met with applicant Nahapet Zakaryan. This is a new facility. A dementia program was included in the plan of operation. A Hospice Waiver has been requested. The current capacity is for six (6) clients, the facility doesn't have any clients at this time. The fire clearance was granted for five (5) non-ambulatory clients and one (1) bedridden client. The facility is one story. At approx. 10:00am, a physical plant tour was conducted inside and out. The facility has three (3) private resident bedrooms. Client room #1 has a direct exit to the outside. There are no fire sprinklers in the facility. Main bedroom hallway and all resident bedrooms were observed equipped with fire doors. All client rooms are set up with beds, nightstands, lamps, chests of drawers, chairs and closet space. The beds are furnished with box springs, comfortable mattress and clean linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket (if needed) and a bedspread. Lighting in the rooms appeared adequate. In addition, no bedroom was used as a passageway to another room, bath or toilet. There is no staff room at the facility. For NOC , there will be awake night staff only. All rooms were free of odors. All window screens were clean and maintained in good repair. There are two (2) bathrooms total. The resident bathroom(s) have a shower with non-skid materials. The toilet and shower have grab bars. The hot water temperature was tested in the bathrooms and the kitchen and was found to be within the range of 105*F and 120*F. Resident and staff records are to be stored inaccessible in the office area, which is currently located next to the dining room. Medications are to be centrally stored in a locked cabinet in the kitchen to the left of the fridge. Continued from 809 The first aid supplies were complete , including a thermometer and a current version of a first aid manual. First aid was observed stored inaccessible in the medication cabinet as well. Kitchen knives are stored in accessible in a drawer to the right of the stove. Stove burners are rendered inaccessible to the residents by placing a safety lock on them when not in use. The supply of dishes, utensils, pots, pans and drinkware is adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of nonperishable food is adequate. There are no pesticides (poisons) or toxins stored in any food storage area or preparation area with utensils. Appliances in the kitchen were clean and all appeared functional at the time of the visit. Trash cans had tight fitting lids. No flies or other vermin were observed. The common areas were appropriately furnished, and the lighting was adequate. There is a television and other entertainment equipment, games and/or activity supplies in the living room. There was sufficient space to accommodate both indoor and outdoor activities. Night lights were maintained in hallways and passageways to non private bathrooms. There is a fireplace in the living room that is non-operable at this time. It is screened and there are no tools. The facility has emergency exit signs . The facility has a furnace, which is able to heat rooms that residents occupy to a minimum of 68 degrees Fahrenheit; and, they have central air conditioning and are able to cool rooms to a comfortable range, not to exceed 85 degrees Fahrenheit. The facility smoke alarm system is battery operated. The smoke detector and carbon monoxide detectors were tested and functioned properly during the time of visit. Fire extinguishers were observed fully charged and purchased in Feb 2023. The laundry room is located on the exterior of the house attached to the home. Cleaning supplies and toxins were observed stored here and the room will be inaccessible to residents in care. Storage area located in laundry room as well. LPA observed extra furniture and other supplies for facility use. The garage is located detached to the home LPA observed extra facility supplies emergency food supplies, extra non-perishable food, and facility equipment, tools and décor. Continued from 809-C There is cabinet located in the main hallway that stored an adequate supply of extra bed and bath linens. Cabinets below the kitchen window were observed to store personal hygiene items (shampoos, soaps) and other supplies for facility use. Cabinets are to be locked and inaccessible to residents in care. There is a functioning telephone on the premises. The emergency exiting plans/sketch are posted at the entrance in the main hallway with the bedrooms. The emergency telephone numbers are posted on the bulletin board in the dining room. Other required postings are posted on the white board as well. The exterior passageways were clean and clear of any obstructions. There is a covered patio area in the rear of the home. LPA observed appropriate furniture for outdoor use. The outside area closest to room #1 was observed to be large enough to conduct outdoor activities. LPA observed a variety of fruit trees and another set of appropriate furniture for outdoor use. The entire property is fenced. The gate to the front courtyard has a gate with a self-latching mechanism for persons to enter the front courtyard. There is no body of water observed at this time. Component III was conducted in conjunction with the visit. No corrections required on a pre-licensing visit at this time. Exit interview conducted. Report issued and provided to Licensee. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your 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.the state’s words, verbatim · CDSS document, Oct 19, 2023