Terner Home 1

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection visit using the complete CARE Inspection Tool. Gohar Hovhannisyan, Staff allowed LPA Yee entry into the facility. The Administrator was contacted by staff and she arrived at 9:56am to conduct the visit. The facility is a single storey family home consisting of a living room, a dining room, a kitchen, 3 resident bedrooms, 2 common bathrooms and a attached garage. The facility is fire cleared for 5 non-ambulatory and one bedridden resident. Bedroom #3 is the room designated for the one bedridden resident. The following was observed on today's visit: The dining room and living room have the appropriate furniture for 6 residents and was clean The fire place was observed with a metal fire screen A carbon monoxide detector was observed in the dining room The kitchen has the standard equipment - stove, refrigerator, toaster oven, coffee maker and dishwasher was observed to be operational and clean. Knives are stored in a locked drawer. sufficient perishable and non-perishable foods were observed in the kitchen and in the garage The three resident bedrooms all contained 2 hospital beds, 2 chairs, 2 lamps, 2 dressers, a shared closet and blinds for privacy. No window bars were observed. Appropriate bed linens were observed on residents' beds minus the comforter due to the heat. Comforter kept in the linen closet with extra bed linens The two common bathrooms were toured. The common bathroom located by the garage is designated for staff use and does not have grab bars. The common bathroom located by resident rooms has a bath tub with a shower. A shower chair, grab bars and non-skid mat were observed. Water temperature tested in the sink read 106.5 degrees Fahrenheit. Per Administrator, the thermostat will be adjusted to a mid-range setting. The facility has 2 fire extinguishers purchased on 8/15/23. One is located in the dining room and one in the hallway by bedroom #3. A first aid kit and first aid manual was observed. Staff have current first aid training. Administrator has a current certificate - expires 12/28/24 The hardwired smoke detectors were tested and were operational Disinfectants, cleaning solutions and laundry detergents are stored in a locked cabinet in the garage. Also located in the garage are the washer and dryer and a second refrigerator for additional food A tour of the outside was conducted at 12:54pm. A covered patio with chairs and coffee table was observed in the backyard. The front yard and back yard were observed to be clean and well maintained. There were no bodies of water observed. There are ramps installed from the living room exit and bedroom #3. Trash cans stored in the front yard were observed opened and overfilled. One container had a discarded garden hose. Lids on the blue and green trash can were also cracked and need to be replaced. The facility has a Infection Control Plan, Plan of Operation and an Emergency Disaster Plan on the premises Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Exit interview was conducted, APPEALS RIGHTS were discussed and a copy was provided.the state’s words, verbatim · CDSS document, Aug 16, 2023

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Salia Walker conducted a pre-licensing visit to the above noted facility. The LPA met with applicant, Siranush Bagdasarian. This is a new facility. A dementia program was included in the plan of operation. A Hospice Waiver has been requested. The facility is one story. At 10:10 a.m., a physical plant tour was conducted inside and out. An approved fire clearance was received, clearing them for five (5) non-ambulatory residents; and, one (1) of bedridden residents. The facility has three (3) shared resident room(s). Resident room #3 has direct exit to the outside, and is cleared for one (1) bedridden resident. All resident 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 and a bedspread. Lighting in the rooms appeared adequate. The bedrooms were large enough to allow for easy passage between the beds and furniture with a wheelchair or walker. In addition, no bedroom was used as a passageway to another room, bath or toilet. There are no staff rooms, ‘awake night staff only’ is required. All rooms were free of odors. All window screens were clean and maintained in good repair. There are two (2) common bathrooms in the hallway. Common bathroom #2 is designated as a staff bathroom. The resident bathroom(s) has 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 stored in a locked closet which is currently located in the hallway upon entry. Medications are centrally stored in a locked closet located in the hallway upon entry. The first aid supplies were complete, including a thermometer and a current version of a first aid manual was assessable in the same location as the central entry point for symptom screening, temperature checks, and sanitation station. Continue on LIC809C.. Kitchen knives are stored in a locked drawer in the kitchen. Stove burners are rendered inaccessible to the residents by removing 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. Trash cans had tight fitting lids. Kitchen, laundry and house cleaning supplies are stored in the facility garage. No flies or other vermin were observed. The common areas were appropriately furnished, and the lighting was adequate. There are televisions and other entertainment equipment, games and/or activity supplies in the living room and dining area. There was sufficient space to accommodate both indoor and outdoor activities. Night lights were maintained in hallways and passageways to nonprivate bathrooms. All ramps were secure and non-slippery and were positioned at the level where wheelchairs and walkers may enter and exit the facility safely. There is a fireplace in the living room. It is screened and there are no tools. Alarms on all exterior doors were engaged at the time of visit and functional. In addition, the physical plant is consistent with the submitted facility sketch/floor plan. The facility had emergency lighting, which included flashlights, or other battery powered lighting, and batteries. 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 hard wired. The smoke detector and carbon monoxide detectors were tested and functioned properly during the time of visit. There are two (2) fire extinguishers throughout the house. They are fully charged with an expiration date of 04/23/2022. The supply of extra bed and bath linens is adequate. Personal hygiene items were adequate and are stored in in each bathroom. Extra incontinence supplies are stored in the facility garage. The garage is accessible from the house; and the door was locked and secure. There is a functioning telephone on the premises. The emergency exiting plans/sketch are posted in the living room. Other required postings are posted in the hallway. The exterior passageways were clean and clear of any obstructions. There is a covered patio area at the back of the house with tables and chairs where residents can sit. The entire property is fenced. The back and sides of the house are separated from the front yard by gates at the north and south side passageways. There are two (2) side gates with a self-latching mechanism for persons to enter the front yard. There are no bodies of water on the premises at this present time. Continue on LIC809C.. Comp III conducted. 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 under the new facility license number, 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 physical plant of this facility location is in compliance with Title 22 regulations at this time. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 8, 2022

Type of visit: Case Management - Other

Licensing Program Analysts (LPA) Ashley Smith conducted an unannounced case management visit at the location today at 9:30 a.m. The purpose of this visit was to conduct a follow up inspection of the property to check on the health and safety of residents in this location. The LPA was greeted by applicant Siranush Bagdasarian and informed them of the reason for the visit. On 02/09/2022, the Department substantiated an allegation of "Unlicensed Care", as it was determined that the Operator retained a tenant (T1) that required care and supervision. Aspects of care were provided which included centrally storing medication, assistance with medication management, bathing, and transferring. An application was submitted via mail with the Department of Social Services for the Licensure of this property on 02/23/2022 under Terner Home 1 (195850248). As of today, the application is still in process. Today, the LPA conducted a physical plant tour and met with applicant Ms. Bagdasarian and Operator Kevin Poghosyan. At the time of the visit, there were five tenants. However, the LPA discovered that out of the five tenants that were identified during the initial visit conducted on 02/09/2022, two out the five tenants moved out (T1, T2). At this time, there were two new tenants identified (T6, T7). The LPA interviewed the two tenants at 9:38 a.m. and 9:45 a.m. At the time of the interview, the LPA did not determine that the staff were providing aspects of care to T6 and T7. The LPA reiterated that during this process, the Operator nor the applicant can accept new tenants at this location, even if tenants move out. At 9:55 a.m., a fire inspector from the LA Fire Department arrived to complete the facility’s fire inspection per the pending application. Per the fire inspector, they will revisit the location pending required corrections. No immediate health and safety concerns were noted during this visit. No deficiencies cited at this time. Report was issued.the state’s words, verbatim · CDSS document, Apr 29, 2022