Facility Evaluation Report

Licensing Program Analyst (LPA) Valeria Conway conducted an announced Pre-Licensing Inspection to the above listed facility. Upon arrival LPA met with Director Anna Hakobyan. Entrance interview conducted.

An application to operate an Adult Residential Facility (ARF) was received by Community Care Licensing (CCL) on 02/02/2024. A Fire Clearance was approved for a maximum capacity of four (4), two (2) ambulatory and two (2) non-ambulatory clients on 05/01/2024. The proposed physical plant is a one (1) story single family dwelling located in a residential neighborhood of Lake Balboa, CA. This facility will be housing clients from Regional Center, and it will be classified as a Level 3 housing. Regional Center application is in process and not approved at the time of the visit. This facility does have a staff room (Room #3). At the time of the visit, the Director and their family are residing at this location temporarily until clients from the Regional Center are admitted. There are no client residing in the facility at the moment.

At 9:45 am a tour of the physical plant was conducted and the following observed:

BEDROOMS: There are four (4) bedrooms, which Room #3 will be for staff use only. Two bedrooms (Room #1 and Room #2) are for single occupancy and Room #4 is for double occupancy. All bedrooms were equipped and supplied with appropriate furniture, bedding, and linens. No client bedroom will be used as a public or general passageway to another room, bath, or toilet. There were no visible hazards or discrepancies observed. Facility does not have auditorial signal at the time of the visit.