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25 | At 9:05am Licensing Program Analysts (LPAs), Angela Panushkina, Joscelyn Martinez and Licensing Program Manager (LPM), Nichelle Gylliard conducted an announced Pre-Licensing visit to the above facility and met with applicant Hovannes Shant Balian. This is a change of ownership application from (Facility #197609734) to (Facility #197610192). LPA team conducted an entrance interview with the Administrator. At the time of this visit LPAs observed and assessed three (3) residents present in the facility. All residents appear to be clean and groomed. Fire Clearance dated 05/20/2021 was received for six (6) bedridden residents. The purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22, Division 6. The facility is a single-story building. Today's site visit consisted of LPAs touring the physical plant inside and outside and observed the following:
The facility has a total of five (5) bedrooms, five (5) of which are designated for resident use. Resident bedrooms were observed to be appropriately furnished. There are two (2) bathrooms in the facility designated for resident use and were observed to have non-skid mats and appropriate grab bars installed. The facility will have awake staff at night and one (1) bathroom is designated for staff use only.
The common areas (living room, kitchen and dining areas) were appropriately furnished and lighting was adequate. The living room has a television and comfortable furniture. Resident and staff records will be stored in a locked cabinet near the entrance area. The fire extinguisher is located in the kitchen and was observed to be fully charged and was last serviced on 06/17/21. Dual smoke and carbon monoxide detectors were located throughout the facility, and at 10:20am they were tested and observed to be operational. At 9:22am the hot water was tested and measured between 115.5 - 118.4 Fahrenheit. There is a functioning telephone on the premises. An emergency exit plan/sketch is posted by the entrance wall with other posting requirements. Medications are stored in a locked cabinet in the living room area. The first aid kit is readily available. Continue on LIC809-C
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