Facility Evaluation Report

At 09:15am Licensing Program Analyst (LPA), Angela Panushkina conducted an announced annual visit to the above facility. LPA met with the Designee, Rena Danielyan, and explained the reason for the visit.

A tour of the physical plant was initiated at 09:30am and the following was observed:

The facility is cleared for a maximum capacity of six (6) residents, of which five (5) can be Non-ambulatory and one (1) Bedridden resident. Bedridden is cleared for bedrooms #1, #2 and #3. Facility has Dementia Care Program. Hospice waiver for six (6) residents is also approved.

Kitchen: The kitchen area is equipped with a refrigerator, microwave oven and sink. LPA observed there to be sufficient stock of one-week perishable foods and two-day non-perishable foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. All knives were observed to be locked in the kitchen drawer. The fire extinguisher was purchased on 01/10/2025 and located by the dining area.

Bedrooms: The facility has a total of five (5) bedrooms, designated for residents’ use. The bedrooms are appropriately furnished with sufficient closet space and have sufficient lighting. Facility has awake staff at night. Emergency call buttons are available and provided to residents. All exit doors have an auditory alarm. LPA tested and observed all call buttons and auditory alarms are in good repair and operational.

Bathrooms: Three (3) out of four (4) bathrooms are designated for residents’ use. Bathrooms have soap, paper towels and all trash cans have a lid. Extra towels and linens were readily available. LPA observed appropriate grab bars and non-skid mats in all bathrooms. The hot water temperature measured at 110.0°F. The facility has one (1) more bathroom (for staff use only), located by the garage.