Facility Evaluation Report

On 1/21/2026 Licensing Program Analyst (LPA) Perchui Milena Khurshudyan arrived at this facility to conduct the required Annual Inspection. Upon arrival, LPA was greeted by the Co-Administrator / DCS Solomon Gochin, who granted access to the facility. LPA explained the reason for the visit. LPA Khurshudyan reviewed the required postings posted on the wall of dining and living room areas and requested staff and residents’ rosters for review.

The inspection tool was used to complete the visit.

At 10:10am LPA, with the help of the DCS/Caregiver, began a physical plant tour of the facility and the following was observed: This is a single-story building with five (5) bedrooms, of which three (3) rooms designated for residents’ use. There are two (2) bathrooms, a kitchen, common areas: living and dining rooms, and an outdoor area. Facility has an approved fire clearance for six (6) Non-ambulatory residents, one (1) bedridden resident for room #1, and a Hospice waiver for three (3) residents.

Kitchen: LPA observed a seven-day supply of non-perishable food, and a two-day supply of perishable food properly stored and labeled. No expired food was observed. Facility stores knives and sharps inside the locked cabinet in the laundry room. Sufficient amount of emergency supply of food / water was readily available. Food storage and preparation areas are clean and inaccessible to pests. LPA observed one (1) fire extinguishers located in the living room. The fire extinguisher was last serviced on 5/13/2025. Dish soap and other chemicals were observed to be stored inside the locked cabinet and inaccessible to residents in care.