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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603495
Report Date: 09/17/2024
Date Signed: 09/17/2024 03:57:05 PM

Document Has Been Signed on 09/17/2024 03:57 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:AREGO HOME INCFACILITY NUMBER:
198603495
ADMINISTRATOR/
DIRECTOR:		MARKOSIAN, ARMENFACILITY TYPE:
740
ADDRESS:1017 WESTERN AVETELEPHONE:
(818) 913-1742
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY: 6CENSUS: DATE:
09/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:04 AM
MET WITH:Armen Markosian, AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an annual required visit. LPA met with Administrator Armen Markosian and explained the reason for the visit. LPA used the Care tool to evaluate the facility. LPA inspected the facility plant, reviewed resident files, staff files, and reviewed staff fingerprint clearances. Facility is approved to retain/accept six (06) hospice residents. There are currently 5 residents on hospice.

The facility is a single story structure located in a residential neighborhood. LPA toured the facility. LPA observed that the facility does not have a swimming pool or other bodies of water. All indoor and outdoor passageways were free of obstruction. There is only one entrance being utilized at the facility, all required posters were posted at the entrance. Sign in sheet, hand sanitizer, gloves and masks are available. Home consists of the following: 4 resident bedrooms, 2 bathrooms , living room, dining area, office area, kitchen, and laundry area. The front yard is well maintained and has a shaded sitting area / gazebo. All resident bedrooms were toured. Each bedroom has a bed, linen, dresser, light, and sufficient closet space. The resident bathrooms have the required grabs bars and non-skid material / mat. The hot water was 120 degrees which is within the required 105 - 120 degrees. The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are clean and seem to be operating properly. Sharps, cleaning supplies are locked and inaccessible to residents.

Carbon monoxide detectors were in compliance and operational. Fire extinguishers were observed fully charged and last purchased in Feb. of 2024.. LPA observed the centrally stored medication area to be locked and inaccessible to residents. The first aid kit was observed and found to be in compliance with the Title 22 Regulations.

Per California Code of Regulations, Title 22, there were no deficiencies observed during the visit.

Exit interview was conducted and the copy of the report was provided to the Administrator .

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Rosaura Valenzuela
LICENSING EVALUATOR SIGNATURE: DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2024
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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