Facility Evaluation Report

On 09/27/24, 9:35AM, Licensing Program Analyst (LPA) Raymond Comer arrived to conduct an unannounced annual visit of the Facility. LPA met with caregiver staff, who contacted Facility Administrator, Nvard Gevorkian, via cell phone. LPA spoke with the Administrator, and the reason for the visit was stated. At around 10:00AM, Administrator Designee, Ani Karapetyan, arrived at the facility to assist with LPA's inspection.

Facility is licensed as a single-story residence, fire clearance for six (6) non-ambulatory, and three (3) bedridden. Hospice Waiver Approved for two (2). Facility has four (4) private bedrooms, one (1) shared bedroom, and two (2) bathrooms.

At 10:15AM , LPA conducted a tour of the physical plant with the Administrator Designee and observed the following:

Physical plant was inspected for cleanliness and condition. Facility’s main door is the primary entry/exit access. Second exit point is located in rear area of facility, adjacent to bedroom#1.

Visitor Sign-in sheet, hand sanitizer, gloves and masks are available. Hand washing, coughing etiquette, and other signage are posted in the bathrooms, and throughout the facility. Room temperature is comfortable; wall thermostat displays a setting of 72.0°F . within the required range. Required postings are prominently displayed and observed to be current. Disaster drills were last conducted on June 2024.

Fire Detection system is present in the facility. Dual smoke/carbon monoxide detectors are located in bedrooms, and throughout the facility. Smoke and Carbon monoxide detectors were tested and function properly. LPA observed fire extinguisher hanging in the hallway, near the dining room. Purchase/Service Date: 09/27/2024.