Tranquil Gardens Elderly Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection. Upon arrival at the location, LPA Yee made contact with the home via the telephone number provided in the facility profile and was informed by Andranik Khachatrian, Corporate Officer that the facility doses not have any residents. LPA Yee explained that an annual inspection is still needed. Kachik Rumelyan, Administrator, was contacted and he arrived at 10:32am to conduct the visit. The reason for today's visit was provided. The home is a single storey family home consisting of a living room, dining room, kitchen, 4 bedrooms, 3 full bathrooms and a attached garage. Located in the back is a ADU with an address of 6702 Ben Avenue and is not part of the facility operations. The facility is fire cleared for 5 non-ambulatory residents and 1 bedridden resident. Bedroom #1 is fire cleared for bedridden use. The home is approved for 6 hospice waivers. On today's visit, LPA Yee conducted a tour or the facility inside and outside to observe the physical plant. The CARE Inspection Tool was not used to conduct the annual inspection today since the facility does not have any residents or staff and there are no files to review. Per tour of the facility, the following were observed: all the required furniture, fixtures and linens were observed in the living room, dining room, kitchen and bedrooms as it was during the Prelicensing visit. The fire place in the living room is capped off and made inaccessible by a fire screen. Bed linens were on the beds and extras observed in the linen closet. continued on LIC809-C Page 2. all three common bathrooms are equipped with grab bars and slip resistant mats. Water temperature was not tested since the water heater was turned off due to not having any residents. The Licensee was reminded to check the water temperature prior to accepting the first resident. no perishable foods for a minimum of 2 days was observed. Non-perishable foods were observed but is not sufficient for a minimum of 7 days and needs to be supplemented and must be maintained on the premises once residents are placed in the home. Currently there are no residents. The Licensee was reminded that the required foods be purchased prior to accepting the first resident. The hardwired smoke detectors located in the resident bedrooms, dining room, living room and the combination smoke/carbon monoxide detectors located in the hallways were tested and were operational. Auditory devices located on the front door, the door in bedroom #1 and the backdoor were tested and were operational. Medications will be locked in a kitchen cupboard. First aid kit was observed with a tweezer, scissors and thermometer. First aid manual was observed. Cleaning solutions are stored in a locked cabinet in the common bathroom located by bedroom #3. The facility has current general liability insurance that meets Title 22 requirements The laundry room located towards the left side of the home was observed with a washer and dryer. The attached garage is used primarily for storage. The backyard was observed with seating and a table. The tent covering is in the process of being replaced due damage caused by the winds. The trash cans are in the process of being replaced by the city. Per the administrator, multiple requests were made and the city has not delivered new trash cans. Per tour of the inside and outside of the home, the areas were observed to be clean. The Licensee will create staff and resident files once the licensee accepts residents and hires staff No deficiencies were cited on today's visit. Exit interview was conducted and copy of this report was provided.the state’s words, verbatim · CDSS document, Dec 8, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Erica Mosley arrived at the facility unannounced to conduct a required annual visit and arrived at the facility at 10:00 a.m. Upon arrival, LPA Mosley rang the doorbell and spoke to the Administrator over the doorbell and informed them of the visit. The Administrator arrived shortly thereafter. The LPA met with KACHIK RUMELYAN– Administrator and explained the reason for the visit. The LPA entered the facility at 10:20 a.m. The facility currently has no residents. The LPA 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. The home is a single-story family home consisting of a living room, dining room, kitchen, 4 bedrooms, 3 full bathrooms and an attached garage. The facility is fire cleared for 5 non-ambulatory residents and 1 bedridden resident. Bedroom #1 is fire cleared for a bedridden resident. KITCHEN: The LPA inspected the kitchen/food service area at 10:22 a.m. Knives and sharps were observed in a locked drawer. Kitchen appliances were in operable condition. The facility has a sufficient supply of seven (7) day non-perishable food. Food pantries were checked for proper labels and expiration dates. The kitchen faucet was measured for hot water temperature, and it measured 108.5 degrees Fahrenheit at 10:31 a.m. LPA observed an adequate amount of emergency food and water located in the kitchen cabinet storage. COMMON AREAS: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. At 11:24 a.m., hardwire combination of smoke / carbon monoxide detector and fire doors were tested and operational at the time of the visit. The fire extinguisher was observed and fully charged on 12/15/2024. The LPA observed required postings throughout the common space. Activities were observed in the common areas. The LPA observed the fireplace to be adequately screened. (PAGE 1) Report Continued on LIC 809C PAGE 2... (PAGE 2) Report Continued from LIC 809 PAGE 1... RESTROOMS: There are three (3) total restrooms all designated for resident use. Restrooms were observed to be equipped with nonskid surfaces. Grab bars were observed in all restrooms. The restrooms were sufficiently stocked with supplies and paper towels. The water temperature was measured in all resident restrooms between 106.5-108.4 degrees Fahrenheit all within the required range. Cleaning supplies are kept in a locket cabinet in the bathroom adjacent to RM#3. BEDROOMS: There are four (4) total bedrooms in the facility; two (2) are designated as private resident rooms and two (2) as shared, double occupancy room. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. GARAGE/OUTDOORS: The backyard has a covered patio area with patio furniture including a table and chairs for resident use. All passageways were observed to be clear. LPA observed one (1) self-latching gate. There were no bodies of water noted at the time of the visit. Washer and dryer are located in the laundry room in the back yard of the facility which remains locked at all times. A sufficient supply of laundry detergent was noted in the locked laundry room along with other chemicals and cleaning products. The garage has extra furniture and supplies and remains locked at all times. MEDICATIONS: Medications are centrally stored in a locked cabinet in the kitchen area. RECORDS: Resident and staff records are stored in a locked filing cabinet which is currently located in the dining room area. LPA obtain the following documents: LIC 500 Personnel Roster and current liability insurance. No deficiencies were cited during today’s inspection. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Dec 17, 2024

Type of visit: Prelicensing

Licensing Program Analyst( (LPA) Chrisitne Yee conducted an announced Prelicensing and Component III visit and met with Kachik Remelyan, Applicant and Designated Administrator. The home is a single storey family home consisting of a living room, dining room, kitchen, 4 bedrooms, 3 full bathrooms and a attached garage. The facility is fire cleared for 5 non-ambulatory residents and 1 bedridden resident. Bedroom #1 is fire cleared for a bedridden resident. The following were observed on today's visit: The living room is furnished with a sofa, love seat, a armchair, a coffee table and a television. Located in the living room is a fire place that is sealed off with a fire screen since the fire place will not be used. The dining room is furnished with a large table and 8 chairs. A filing cabinet to store resident and staff files were observed. The kitchen is equipped with a stove, dishwasher and a refrigerator. Medications will be stored in a locked kitchen cabinet and sharp knives stored in a locked drawer. 8 sets of dinner plates, salad plates, bowls, glasses and 12 coffee cups were observed. Also observed were 8 of each - forks, knives, tablespoons and teaspoons. Pots, pants and cooking utensils were observed. Dish soap will be stored in a locked cabinet under the kitchen sink. No perishable foods were purchased for today's visit but will be purchased prior to accepting the first resident. Non-perishable foods for 7 days need to be supplemented to meet Title 22 requirements. Located in the kitchen is the only fire extinguisher, purchased on 9/30/23. Bedrooms #1 and Bedroom #3 both contain I bed, 1 chair, 1 night stand, 1 lamp, a dresser and a built in closet in bedroom #1 and a portable closet in bedroom #3. The required bed linens were observed except no blankets were observed. The beds need box springs. Blinds were observed on bedroom windows. Blinds or curtains needs to be hung on the door in bedroom #1 to allow for privacy. The beds are too low and need box springs. The door in Bedroom #1 leads out to a ramp. Bedrooms #2 and Bedroom #4 are furnished with 2 twin beds, 2 night stands, 2 chairs, 2 lamps, 2 dressers and a shared closet. The required bed linens were observed except there were no blankets. Box springs are needed for the beds. Blinds were observed on the windows. The common bathroom located closes to bedroom #1 is designated for staff use and is equipped with a tub and shower head, a toilet and a sink. A non-skid mat was observed but no grab bars were installed. Water temperature was tested and read 111.6 degrees Fahrenheit. The common bathroom by bedroom #3 has a shower, a toilet and a sink. Toxins and cleaning supplies are stored in a locked cabinet. 18 bath towels, 24 wash clothes and 24 face towels were also observed in the bathroom cabinet. Hygiene products such as tooth paste, tooth brushes, shampoos are stored in cubbies assigned to each resident. Toilet paper and paper towels were also observed. Water temperature was tested and read 106.5 degrees Fahrenheit. The common bathroom by bedroom #4 is equipped with a shower, a toilet, a sink, grab bars and a non-skid mat. Water temperature was tested and read 108.2 degrees Fahrenheit. The hardwired smoke detectors were tested and were operational. The carbon monoxide detectors located in the hallways were tested and were operational. The first aid kit was reviewed and contained the required bandages, tweezer, scissor and a thermometer. A first aid manual was observed. The backyard and front yard was observed to be clean. 4 rattan chairs and 2 rattan love seats were observed covered with a fabric gazebo in the backyard. No bodies of water was observed. The following deficiencies need to be corrected prior to being licensed: Blankets need to be provided to all the residents and extra quantities to be purchased in quantities to allow for weekly changing or as frequently as needed Blinds/Curtains need to be placed on the door in bedroom #1 Box springs need to be obtained for all residents bed Grab bars need to be installed in the staff bathroom located by bedroom #1 Non-perishable foods need to be supplemented. Applicant will contact LPA Yee once the corrections have been completed. The following needs to be completed prior to accepting the first resident: perishable foods for a minimum of 2 days must be purchased liability insurance must be purchased to meet Title 22 requirements of $1 million per occurrence and for a total annual aggregate of $3 million. Component III was conducted with Kachik Rumelyan. Exit interview was conducted.the state’s words, verbatim · CDSS document, Dec 18, 2023

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Name - Andranik Khachatrian CEO/Kachik Rumelyan Administrator Interview Method: Telephone interview On November 8, 2023, Applicant/Administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and 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. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of the 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, Nov 8, 2023