Facility Evaluation Report

On 8/4/2023 at 9:00 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an announced pre-licensed visit and met with Applicant Hegine Abeshyan for the purpose of conducting a Pre-Licensing Inspection / Component III visit. The facility has an approved fire clearance to be licensed to serve four (4) ambulatory, (1) non-ambulatory, and (1) bedridden Residents age 60 and above. The facility is a single-story home: 3 bedrooms, 2 bathrooms, dining room, living room, kitchen, laundry room, nook, backyard and an attached garage.

The physical plant was toured inside and out alongside applicant Hegine Abeshyan. Pre-Licensed Inspection Tool was used.

· Each bedroom is designated as a private bedroom. Bedrooms are equipped with one bed, night stand, chair, sufficient lighting, appropriate closet, and drawer space.

· All beds had the required linen/supplies which include, pillowcase, mattress pads, fitted sheet, blanket and bedspreads. Mattresses and bedsprings are in good repair.

· Bedrooms are large enough to allow for easy passage between and comfortable for usage of beds and other required items of furniture.

· Sufficient supply of linens available to permit weekly changing and are stored in storage cabinet.

· Sufficient personal hygiene supply available.

· All (2) bathrooms have a working toilet, wash basin, and showers. All showers have a grab bars and non-skid mats.

· There are enough bath towels, hand towels and wash cloths for all clients.