White Diamond Residential Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tihesha Smith made an unannounced 1-year inspection to this facility. LPA Smith was greeted by staff and disclosed the purpose and the administrator who arrived later. LPA Smith conducted a tour of the physical plant at approximately 12:00 pm to ensure there are no health and safety hazards, and facility is in compliance with Title 22 Regulations. Common areas were observed for the ability to safely serve the needs of the residents. These included the open concept kitchen, living and dining room areas. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be clean, sanitary and have adequate seating for residents. LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The kitchen food supply was observed and sufficient for the four (4) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meat and frozen foods. Sharps are stored in kitchen drawer. Sharps observed to be locked and inaccessible to residents in care. Medication and first aid kits stored in standalone medication cabinet near the laundry room: observed to be inaccessible to residents. Toxins are stored and locked under kitchen sink and observed to be locked and inaccessible to residents. The facility has a total of four (4) bedrooms and two (2) bathrooms. One of the bedrooms is designated as a staff room. The residents’ bedrooms were properly furnished with at least one chair, nightstand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, and blankets. (continued from 809) Each bathroom has the following items available: hand soap, paper towels, and trash cans. The hot water temperature was measured for the bathroom to ensure it is within the required range for residents’ comfort and safety. The water temperature for the bathroom was 109.6 -degrees Fahrenheit. There is one (1) wall mounted fire extinguisher in the facility near the dining room table. The fire extinguisher was observed to be charged. Carbon monoxide and smoke detectors were tested and operable at time of visit. Backyard has the following: Patio with tables and chairs. Patio furniture observed to be in good repair with adequate seating for residents. Garage is attached but no in door access: used to store emergency water and additional foods, PPEs. Facility grounds were free of hazards. At approximately 12:40 pm, LPA reviewed four (4) resident files each file contained admission agreements, assessments, and personal rights documentation. Two (2) random staff files reviewed. Staff files had clearances and current First aid and CPR. No deficiencies observed at time of visit. Exit Interview Conducted /Copy of the Report Issuedthe state’s words, verbatim · CDSS document, Jan 12, 2026

Type of visit: Prelicensing

Licensing Program Analysts (LPAs) Nadia Shahbazian and Leslie Ngo-Castaneda conducted a Pre-Licensing Inspection with the licensee, Ani Hakobyan. An application to operate a Residential Care Facility for the Elderly (RCFE) was approved by Community Care Licensing (CCL) on June 1, 2024. A fire clearance was approved on September 5, 2024 for five (6) non-ambulatory residents and one (1) bedridden resident, for a total capacity of six. The applicant was granted a hospice waiver to retain four (4) residents. The smoke alarms and carbon monoxide detectos are dual and inter-connected. The facility has a brand new fire extinguisher purchased on 06/08/2024. Fire extinguisher is located at the dining room.With the assistance of the licensee, a tour of the physical plant was initiated and the following was observed: KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, stove/oven, and sink. There was an adequate supply of perishable and non-perishable food items observed. Knives were observed locked in a kitchen drawer. Cleaning supplies observed locked underneath the kitchen sink and the laundry room. BEDROOMS: There are four (4) bedrooms, three (3) are designated for client use. All three bedrooms will be shared. Bedroom #1, bedroom #2, and bedroom #3 are shared and will be for residents use. Bedroom #4 is located by the entrance of the facility and will be be used as staff room. All bedrooms were furnished with beds, night stand, dresser, beddings, and linens. The bedrooms have sufficient lighting. Per STD 850, bedroom 3 is designated for 1 bedridden resident. BATHROOMS: The facility has two and half (2.5) bathrooms. Bathroom #1 is located by the hallway in between bedroom #2 and bedroom #3. Hot water measured at 108 degrees Fahrenheit. Bathroom #2 is located inside staff bedroom #4. Half bathroom (0.5) is located across the locked laundry room by the kitchen. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. Continue to LIC 809-C COMMON AREAS: These included the living room and dining room areas. The living room has couches, telephone/cable and television. The dinning table is enough to fir eight (8) residents. Office is located beside the dining table. Fire place is close, non-operational and block off. LAUNDRY ROOM: The laundry area is located in a separate, covered space, located in between the dinning room and staff bathroom. It will be kept locked and inaccessible to residents. MEDICATIONS: Medications are kept locked in the lobby cabinet. First aid kit is complete. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The backyard of the facility is large enough to hold outdoor activities. There was backyard furniture appropriate. There is no swimming pool. In addition to the Pre-Licensing inspection, a Component III power point presentation was also held. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 7, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): N/A COMP II Participants: licensee/administrator Ani Hakobyan Interview Method: Telephone interview On 11/26/2024, 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 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 26, 2024