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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603605
Report Date: 12/26/2024
Date Signed: 12/26/2024 02:51:40 PM

Document Has Been Signed on 12/26/2024 02:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:ARARAT GARDENSFACILITY NUMBER:
198603605
ADMINISTRATOR/
DIRECTOR:		KESHISHYAN, VARSENIKFACILITY TYPE:
741
ADDRESS:1230 EAST WINDSOR ROADTELEPHONE:
(818) 244-7219
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY: 175CENSUS: 70DATE:
12/26/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Charles Brugh-Executive Director TIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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Licensing Program Manager (LPM) Naira Margaryan, Licensing Program Analysts (LPAs) Leslie Ngo-Castaneda and Angelica Segovia conducted unannounced Case Management: Health and Safety visit to the facility. LPM and LPAs met the Executive Director (ED) Charles Brugh and he was informed that this case management visit was conducted to discuss the recent visit conducted by the Fire Inspector from Glendale Fire Department.

During Licensing Inspection conducted by the Department on 09/24/2024, it was noted that the facility retains non-ambulatory residents on the 2nd, 3rd and 4th floors without having appropriate approved fire clearance. The facility requested a new fire clearance to get approval for the upper levels. However, on 11/19/2024 the fire clearance was denied. Prior to this visit, Fire Inspector from GFD contacted community care Licensing Department and informed the following.

“On 11/19/2024, Glendale Fire Department (GFD) performed an inspection at the facility. Upon review of the application, GFD has denied the request to increase the non-ambulatory and bedridden counts for this site. In addition, the applicant contacted the Fire Department and request to indicate that all 4 floors would be permitted to allow non-ambulatory and bedridden patients. GFD was unable to accommodate this request. Based on GFD inspection, all non-ambulatory and bedridden patients shall remain on the 1st floor as per Tittle 22 of CCR or have direct access to the outside from their rooms.

Previous fire clearance indicates:

Five (5) Bedridden.

Seventy-five (75) non-ambulatory

One hundred (100) ambulatory.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
LICENSING EVALUATOR SIGNATURE: DATE: 12/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ARARAT GARDENS
FACILITY NUMBER: 198603605
VISIT DATE: 12/26/2024
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In addition, it indicates that all rooms on the first floor are approved to be used for bedridden and/or non-ambulatory residents.

According to fire inspector who visited the facility, modifications to bed counts on the first floor can be approved by Glendale Fire Department, as long as non-ambulatory and bedridden residents remain on the 1st floor.

During this visit LPM Margaryan, LPAs Ngo- Castaneda and Segovia spoke with ED, and explained that at this time the facility is not in compliance with the Title 22 Regulation regarding approved Fire clearance.

ED indicated that after the visit from the fire Department, RD and Executive Management are working on it and trying to determine how they are going to resolve this issue with minimal effect to residents that should be relocated to different rooms.

The meeting was held with all residents, and they were informed about upcoming changes of residents’ rooms.

Based on today’s residents Roster, there are more than ten (10) non-ambulatory residents residing on 2nd, 3rd and 4th floors.

ED stated that they will start moving residents as soon as possible.


No other immediate health and safety issues observed. Exit interview conducted and a copy of the report was issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2024
LIC809 (FAS) - (06/04)
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