Facility Evaluation Report

Licensing Program Analyst (LPA) Ashley Calderon conducted an announced pre-licensed visit and met with Applicant Ovsep Gasardzhyan for the purpose of conducting a Pre-Licensing Inspection / Component III visit.

The facility has an approved fire clearance dated 8/3/23 to be licensed to serve four (4) non-ambulatory elderly residents. The facility is a single-story home: 4 bedrooms, 2 bathrooms, living room, and kitchen. The backyard has two locked tool sheds used for storage, facility located in the City of Duarte, CA.

Detached garage was converted to an ADU, permit dated 9/16/2022, permit was provided to LPA. ADU has a separate address 633 Camino Real. Applicant will send updated sketch to CCIB. Residents and Staff will not have access to the ADU. Applicant will place fencing around ADU for inaccessibility from the backyard of the licensed facility and Applicant will contact licensing when construction is done.

The physical plant was toured inside and out alongside Ovsep Gasardzhyan. Pre-Licensed Inspection Tool was used.

· There is a locked storage area that is located for medication in the hallway cabinet.

· Cleaning supplies are kept separate from food and locked and located in the side closet outside the kitchen door.

· Facility walls, ceilings, floors, window screens and areas around the facility are clean and in good repair.

· Fire extinguishers, carbon monoxides and smoke detectors are operating properly.

· Doors and passageways are free of obstruction.

· There are no pools/bodies of water at this facility.

· Facility does not have firearms on premises.