Senior Care Records.

Facility Evaluation Report

Peaceful Pines Senior Living Corp, Simi Valley07/31/2025Licence 565850569

Capacity6
Census5
Date signed07/31/2025 01:41:12 PM
Name of licensing program analystBrian Balisi
Name of licensing program managerDesaree Perera
The inspector’s account

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with staff and explained the reason for the visit. Licensee Andranik Kapikyan arrived shortly after. LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations.

At approx 10:45 a.m. LPA observed five (5) resident bedrooms , which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The resident bathrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured between 105 - 120 degrees Fahrenheit.

LPA observed personal hygiene supplies, toiletries and activities to be be stored and inaccessible in an entry closets by the front door.

The LPA inspected the kitchen/food service area. Kitchen appliances appeared clean and to be in operable condition at the time of the visit. At approx 10:55 a.m. LPA observed staff cleaning common areas. The facility has a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for dates and expiration dates. Knives and sharps were observed locked and inaccessible to residents in care.

At the time of the visit, the common area furniture's were observed to be in good condition. A sufficient supply of clean linen and towels were observed stored in a hallway closet. The facility maintained a comfortable temperature of 72 degrees Fahrenheit.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction