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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610722
Report Date: 03/20/2025
Date Signed: 03/20/2025 12:20:53 PM

Document Has Been Signed on 03/20/2025 12:20 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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:APEX SENIOR CAREFACILITY NUMBER:
197610722
ADMINISTRATOR/
DIRECTOR:		TOROSYAN, AIDAFACILITY TYPE:
740
ADDRESS:19525 STAGG ST.TELEPHONE:
(818) 818-8360
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY: 6CENSUS: 0DATE:
03/20/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Aida Torosyan, AdministratorTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
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At 10:00 AM, Licensing Program Analyst (LPA), Angela Panushkina conducted an announced Pre-Licensing visit to the above facility and met with the Administrator, Aida Torosyan,and explained the reason for the visit.

Fire Clearance dated on 02/04/2024 is approved for two (2) Ambulatory residents in rooms #1 & 2 only, three (3) Non-ambulatory residents of which one (1) can be Bedridden in bedroom #3. The facility is a single-story building. LPA conducted a physical plant tour, inside and out, and observed the following:

Kitchen: The LPA observed the kitchen is equipped with a refrigerator, oven, and a sink. Stove was observed in a good working condition. Adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6) was available. All knives and sharps are observed to be locked and inaccessible to residents in care. LPA observed a Fire Extinguisher and was last purchased on 11/13/2024.

Laundry: Laundry area is located by the kitchen. The washer/dryer appear to be in good condition. Laundry supplies, chemicals and detergents are kept locked in the hallway closet, and inaccessible to residents in care.



Bedrooms: There are four (4) bedrooms designated for residents use. LPA observed that all bedrooms are furnished with beds, dressers and required bedding and linen. All residents also will have a call button available for an emergency assistance. The bedrooms have sufficient closet space and have sufficient lighting. Auditory alarms were tested and observed to be operational. The facility will have an awake staff.

Bathrooms: At 10:45am LPA observed all bathrooms are clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed appropriate grab bar and had non-skid mat.
Continue on LIC809-C
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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: APEX SENIOR CARE
FACILITY NUMBER: 197610722
VISIT DATE: 03/20/2025
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 LPA observed appropriate hand washing signs posted in each bathroom. All trash cans in bathrooms had fitted lids to protect from cross contamination.

Medications: Medications and files will be stored in file cabinets located by the dining/office areas. Both cabinets will be kept locked and inaccessible to residents in care.

Common Areas: The facility maintains a comfortable temperature at 70°F. The living room and dining area appeared clean and were properly furnished. No obstructions and or tripping hazards throughout the facility.

Smoke detectors/carbon monoxide. Dual smoke and carbon monoxide detectors were located throughout the facility, and at 10:55am they were tested and observed to be operational.

Outside areas: At approximately, 11:00am LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for clients. The outdoor area was free of visible immediate hazards. LPA discussed the importance of maintaining the care and supervision to meet the needs of residents. There are no bodies of water.



Component III was conducted at 12:00pm.

Pursuant to Title 22, Division 6 Chapter 2, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised and a copy of this report will be emailed.

Exit interview conducted and copy of this report signed and delivered.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC809 (FAS) - (06/04)
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