Facility Evaluation Report

At 10:00 AM Licensing Program Analysts (LPAs), Nadia Shahbazian and Evelin Rios, conducted an unannounced annual inspection at the facility. LPAs met with the staff and explained the reason for the visit. LPA requested the staff to contact the administrator, Narine Hannesyan, who was not in the facility. Later on the staff received a call from administrator’s son, Sam, informing that administrator is unable to meet at this time. Sam provided information and stated the current census is 4.

At approximately 10:30 am LPAs conducted a physical plant tour and observed the following:

The total capacity of the facility is approved for six (6) residents; LPAs observed four (4) residents. LPAs were informed that resident in room three (3) passed away approximately a month ago. LIC 624A Death Report was not submitted to CCLD.

Common Areas : The entry hall was furnished with a dresser. LPAs observed a complete first aid kit in the drawer but there was no first aid manual. LPAs observed three (3) scissors and two (2) sharp nail clippers in an unlocked drawer, accessible to the residents. The living room and dining area is a large space, with the office space in the corner of the dining room. The office area included the telephone for resident use. The living area appeared to be clean and was properly furnished with seating for the capacity of the facility.