Facility Evaluation Report

Licensing Program Analyst (LPA) Tihesha “Lynn” Smith conducted an unannouced Annual Required visit to this facility . LPA was greeted by facility staff, Catherine Wayro, who was observed wearing a mask and took LPA's temperature upon entry and Covid symptoms questions contained on a separate form. LPA explained the reason for the visit. Administrator Yeranuhi Ghazaryan was called at 10:38 am and arrived after.

LPA conducted a tour at 12:45 PM of the physical plant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations The facility has working interconnected smoke alarms and carbon monoxide alarms that are hard wired and battery operated. All smoke alarms were tested and function properly. The carbon monoxide detector was tested and functions properly. The fire extinguisher was current with receipt.

Staff confirmed there are four (4) ambulatory residents residing in facility. The living area had sufficient lighting, adequate seating, was clean and properly furnished.

The kitchen appeared clean, the appliances and fixtures were functional. The kitchen food supply was observed and sufficient for the four (4) clients currently residing there. Two (2) days of perishable fruits, vegetables, milk and eggs observed with juice. The freezer is stocked with meats and frozen vegetables. There is also a second refrigerator and pantry in a converted garage stocked with additional perishable and non-perishable food, canned goods, water and PPEs. The sharps are locked in a cabinet above the refrigerator in the kitchen. The cleaning supplies were locked in the cabinet under the kitchen sink.