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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331881505
Report Date: 05/13/2024
Date Signed: 05/13/2024 02:22:43 PM

Document Has Been Signed on 05/13/2024 02:22 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:DESERT ROSE ASSISTED LIVING INCFACILITY NUMBER:
331881505
ADMINISTRATOR/
DIRECTOR:		KERIMYAN, LILITFACILITY TYPE:
740
ADDRESS:74132 WINDFLOWER COURTTELEPHONE:
(818) 335-5651
CITY:PALM DESERTSTATE: CAZIP CODE:
92211
CAPACITY: 6CENSUS: 0DATE:
05/13/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Applicant, Lilit KerimyanTIME VISIT/
INSPECTION COMPLETED:
02:25 PM
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Licensing Program Analyst (LPA) Janette Romero made an announced visit to the facility to conduct a pre-licensing evaluation. The facility submitted an application to the Centralized Applications Bureau (CAB) to operate a Residential Care Facility for the Elderly. LPA met with Applicant, Lilit Kerimyan, whose administrator’s certificate expires on 1/26/2025.

LPA toured the facility's interior and exterior with Applicant, Lilit Kerimyan. The facility is made up on a one-story home with four resident (4) bedrooms, three (3) bathrooms, a kitchen, dining room, living room, and attached car garage. Indoor and outdoor passageways are free of obstruction. There are no bodies of water on the premises. Applicant Kerimyan tested one of the smoke alarm/carbon monoxide detectors and LPA found it to be operational. LPA observed charged fire extinguishers mounted throughout the facility. The facility has a central heating and air conditioning system installed with a central panel located in the hallway to control entire house. All resident bedrooms are adequately furnished with a bed, chair, closet, appropriately sized linens, adequate lighting, and a smoke alarm/carbon monoxide detector. All bathrooms have a working toilet, wash basin, and have toilet paper, paper towels, and soap readily available. Bathrooms have non-skid mats and grab bars in the showers and near the toilets. LPA tested the hot water temperatures in each bathroom, which measured at 107.1-, 110.3- and 112.4-degrees Fahrenheit. LPA toured the kitchen and observed the facility has a sufficient supply of dishes, glasses, utensils, pots, pans and a 7-day supply of non-perishable foods for the approved capacity. Knives/sharp instruments will be secured in a kitchen drawer. Medications will be centrally stored in a locked cabinet near the kitchen. Cleaning solutions and disinfectants will be secured in the laundry room. The facility has a confidential storage area designated for staff and resident records. Emergency phone numbers, residents’ personal rights and Long-Term Care Ombudsman information are visibly posted near the front entrance.

During today's visit, LPA did not observe any issues or concerns, and there are no corrections required. Final approval of licensure will be granted by the CAB analyst. An exit interview was conducted, and a copy of this report was reviewed and provided to Applicant Kerimyan.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE: DATE: 05/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/13/2024
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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