Facility Evaluation Report

On 6/11/2025 at approximately 10:00 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by the caregiver and stated the reason for their visit. The Administrator Lusine Werdian arrived shortly after to assist with today’s visit.

LPA asked for the census and Staff/Client Roster. LPA conducted a physical plant tour at approximately 11:30 AM and the following was noted:

The facility is a single-story building with five (5) bedrooms and three (3) bathrooms currently occupying four (4) clients. There is one (1) designated staff room with one (1) private bathroom. The facility has an approved fire clearance for four (4) ambulatory clients. The facility is vendor through North Los Angeles Regional Center (NLARC) and is being operated at a Level III Adult Residential Home. Sign in sheet, hand sanitizer, gloves and masks are available.

Common areas: The living room and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 71°F. LPA observed the fire extinguisher to be located near the kitchen and dated 01/20/2025. LPA observed required postings such as Rights of Individuals with Developmental Disabilities, Facility License, and Emergency Disaster Plan located throughout the common areas. A working telephone was observed.

Kitchen: The kitchen was observed to be clean and free from pests. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. The knives/sharps were observed to be kept in a locked kitchen drawer. The medications and staff/client files were observed to be kept in locked cabinets located the kitchen area. (continued on LIC 809-C)