197610192-9-15-2022-31-AS-NRED-CJAN3K-20220915100627

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197610192
Report Date: 09/15/2022
Date Signed: 09/15/2022 10:06:47 AM

Document Has Been Signed on 09/15/2022 10:06 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME:	BEST YEARS ASSISTED LIVING, INC		FACILITY NUMBER:	197610192
ADMINISTRATOR:	BALIAN, HOVANNES SHANT		FACILITY TYPE:	740
ADDRESS:	7630 WILBUR AVE.		TELEPHONE:	(818) 732-7737
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY:	6	CENSUS: 2	DATE:	09/15/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Cristina Mihranian		TIME COMPLETED:	10:15 AM

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At 9:00 a.m. on 09/15/2022, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual visit. LPA met with staff and later Administrator and disclosed the reason for the visit. LPA and Administrator toured the facility inside and out.

The facility was last visited on 09/03/2021 for a prelicensing inspection. It is a single story building with 5 bedrooms, 3 bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for 6 residents, of which 6 may be bedridden. Approved hospice waivers for 6.

Signs at the main entrance included the facility’s visitation policy, masking policy, and a sign showing “No smoking – Oxygen in use”. LPA was screened for infectious disease upon entry. The screening station contained a digital thermometer, gloves, hand sanitizer, and a visitor log. The visitor log tracked temperature and contact information. LPA advised to adjust the visitor log to also track symptoms. Postings inside included confidential complaint contacts, COVID precautions, Emergency Disaster Plan, facility license, Non-discrimination policy, and resident rights. A fully stocked first aid kit was located in an office area near the main entrance.

LPA observed an adequate supply of perishable and non-perishable food in the kitchen and in the garage. At approximately 9:14 a.m. LPA measured the refrigerator and freezer temperatures to be 39 and 0 degrees Fahrenheit, respectively. At the same time, LPA observed a fully charged fire extinguisher hung in the kitchen. It was last inspected on 07/11/2022. The stove hood was clean. All appliances were functional and sanitary. Sharps were locked under the counter top. A laundry area near the kitchen contained an operable washer and dryer. Cleaning solutions were locked near the appliances. The garage was locked and contained extra food, a second refrigerator, PPE, incontinence supplies, and assistive devices. Walls, floors, ceilings, windows, screens, and blinds in the common areas were clean and in good repair. At 9:18 a.m. LPA measured the room temperature to be 78 degrees Fahrenheit.

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: BEST YEARS ASSISTED LIVING, INC	FACILITY NUMBER: 197610192
	VISIT DATE: 09/15/2022

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The facility had 5 bedrooms. 3 were private and 2 were shared. All bedrooms contained a chair, nightstand, lamp, storage, and bed with adequate bedding. All furnishings were clean and in good condition. Residents were observed watching television in their rooms. The facility has 3 bathrooms. All bathrooms contained liquid soap, paper towels, handwashing instruction sign, trash can with a tight fitting lid, grab bars near the toilet and shower, and a non-skid mat in the shower. At 9:34 a.m. LPA measured the water temperature in the private bathroom adjacent to Bedroom #5 to be 110.6 degrees Fahrenheit.

At 9:38 a.m. LPA tested the dual-purpose smoke and carbon monoxide detector to be operational. All detectors were hard-wired, and the facility uses fire sprinklers. All auditory alarms were on, functioning, and centrally wired. LPA observed a bench swing and covered patio furniture in good condition. The emergency exit path was unlocked and free from debris.

During today's inspection, the facility is in compliance with Title 22 regulations. No citations issued.

Exit interview conducted. Copy of report provided.

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022

LIC809 (FAS) - (06/04)

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