Sunland Care Home

Type of visit: Required - 1 Year

On 8/20/2025 at approximately 09:30 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by the caregiver and stated the reason for their visit. The Administrator, Razmaser Gevorgyan arrived shortly after to assist with today’s visit. LPA asked for the census, Staff/Resident Roster, and Liability Insurance. LPA conducted a physical plant tour at approximately 11:00 AM and the following was noted: The facility is a single-story building with three (3) bedrooms and two (2) bathrooms. The facility is currently occupying four (4) residents. There is no designated staff room. The facility has an approved fire clearance for six (6) non-ambulatory residents of which one (1) may be bedridden. Hospice waiver approved for six (6). Common areas: The living room and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 70°F. LPA observed a fire extinguisher to be located near the kitchen and dated 11/12/2024. LPA observed required postings such as Long-Term Care Ombudsman, Emergency Disaster Plan, and Personal Rights to be located alongside the entrance. A working telephone was observed. LPA observed the fireplace to be covered and inaccessible to residents. Kitchen: The kitchen was observed to be clean and free from pests. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. Knives/sharps were observed to be kept in a locked kitchen drawer. The cleaning solutions/toxins were observed to be kept locked underneath the kitchen sink. Kitchen appliances were observed to be working and in proper condition. (continued on LIC 809-C) Bedrooms: The residents’ rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are lighted appropriately. Extra linens/covers were observed to be stored in cabinets located within the hallway’s passageway. Bathrooms: The bathrooms were checked for cleanliness and proper operation. The hot water temperature was measured within regulations. LPA observed appropriate grab rails and slip-resistant mats to be in proper condition. Backyard: The backyard of the facility is equipped with a designated shaded area with outdoor furniture for residents. LPA observed there to be a locked shed. There is no body of water located at the facility. Garage: The garage is located outside in the backyard separate from the facility. The garage was observed to be kept locked and used for storage purposes. Extra refrigerator and freezer with additional food for residents was observed. Laundry Room: The laundry appliances were observed to located within the garage. LPA observed cleaning solutions and toxins stored appropriately within the laundry room and inaccessible to residents. The laundry appliances were observed to be working and in proper condition. Medications: The medications along with staff and residents’ files were observed to be kept in a locked filing cabinet located in the kitchen. First-aid kit observed to be equipped with but not limited to bandages, scissors, digital thermometer, tweezer and First-Aid Manuel. Smoke detectors and carbon monoxide observed to be working properly and were tested. Residents/Staff Records: LPA conducted a complete file review of resident records. Resident records appeared to be complete and updated. Staff records: LPA conducted a complete file review of staff records. Staff records appeared to be complete and updated. There were no immediate health and safety hazards observed during the day of inspection. Exit interview conducted and a copy of this report was provided to the Administrator.the state’s words, verbatim · CDSS document, Aug 20, 2025

Type of visit: Prelicensing

At 10:30AM, Licensing Program Analyst (LPA) Leizl de la Cerra arrived at the facility to conduct an unannounced Pre-licensing visit of Sunland Care Home. LPA met with Licensee/Administrator Zhirayr Ayvazyan and Applicant/Administrator,Razmaser Gevorgyan. This is a Change of Ownership Application for a Residential Care Facility for the Elderly. Facility is a single-story house with three (3) bedrooms and two (2) bathrooms. Fire Clearance was approved on 01/08/2024 for a capacity for six (6) residents, 5 of which can be non-ambulatory and 1 bedridden. A hospice waiver for 6 residents has been approved. LPA conducted a physical plant tour inside and outside premises at 11:00AM. LPA observed the following: COMMON AREA: LPA observed the living room and furniture to be clean and in good repair. The fireplace located in the living room is adequately closed and inaccessible. The facility maintains a comfortable temperature at 76 degrees Fahrenheit. The air conditioner is operational. The facility smoke alarm system is hard wired and interconnected. The facility uses a dual Carbon Monoxide/Smoke alarm detectors all over the common areas of the facility. At 11:40AM they were tested and deemed operational. Facility maintains a telephone land line and it was observed to be operational. Required postings were observed in the entry area. KITCHEN AREA: LPA observed the kitchen area to be in good repair and sanitary. The kitchen is equipped with a refrigerator, dishwasher, microwave, oven and sink. Kitchen appliances are well maintained and functional. LPA observed adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents in care. Water temperature was measured at 115.6 degrees Fahrenheit. A cabinet with a lock underneath the kitchen sink stores kitchen cleaning solutions and will remain locked and inaccessible to residents in care. CONTINUED - LIC809-C. By the dining area. LPA observed a four drawer locked cabinet that contains all resident and staff records and medications. LPA observed the four drawer locked cabinet is inaccessible to residents in care. The fire extinguisher was observed to be fully charged and was last purchased on 02/13/24. The first-aid kit is complete. Bedrooms: Facility has three (3) bedrooms, all of which are shared. All bedrooms were toured and were observed with the appropriate furniture, such as beds with clean beddings, night stands, closet space with dressers and sufficient lighting was observed at each bedroom. Extra linens and towels were observed in the hallway cabinet. Bathrooms: Facility has two (2) bathrooms. Bathrooms were observed to be clean. Appropriate grab bars and non-skid mats were observed. Hygiene supplies are available to the residents. Water temperature was measured at 116.2 degrees Fahrenheit. Garage Area: Facility has a detached garage in the backyard. Facility has a washer and dryer located inside the garage. Laundry chemicals are stored in the garage and the garage will be used as a storage area and stores extra food supplies, toiletries, PPE supplies, and incontinence supplies. The detached garage has a lock and will remain locked and inaccessible to residents in care Surrounding Grounds: LPA observed appropriate outdoor furniture with a shaded area for residents. There is a locked shed in the backyard that is used for storage and will remain locked and inaccessible to residents in care. There are no bodies of water. No deficiencies were observed. Component III Orientation was conducted with the administrator/applicant during the visit. LPA de la Cerra will notify the Centralized Applications Bureau (CAB) Analyst of the completed Change od Ownership Pre-Licensing inspection. The CAB Analyst will notify applicant when license is approved. Exit interview was conducted and a copy of the signed report given to the applicant.the state’s words, verbatim · CDSS document, Jul 9, 2024

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for Elderly (RCFE) Application Type: Change in Ownership (CHOW) Capacity: 6 Census (if any clients in care): 6 COMP II Participants: Razmaser Gevorgyan, Applicant/Administrator Interview Method: Telephone interview On June 7, 2024 @ 9:00 AM, applicant/administrator participated in COMP II. Identification of the applicant/administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant/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. During COMP II, CAB analyst confirmed Applicant/Administrator’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 Readiness Exit interview conducted with Applicant/Administrator. Report sent via email and request to return sign copy back to CAB by end of business day today.the state’s words, verbatim · CDSS document, Jun 7, 2024