Facility Evaluation Report

On 7/28/2026 at approximately 8:05AM, Licensing Program Analyst (LPA), Gina Saucedo conducted an unannounced annual visit to the facility and LPA stated the reason for their visit to the Administrator, Romik Rostomyan.

LPA asked for the census, staff and resident files. LPA conducted a physical plant tour at approximately 9:50AM and the following was noted:

The facility is a single-story building with three (3) bedrooms, two (2) bathrooms and one separate (1) shower. The facility is currently occupying four (4) residents. There is no designated staff room. The facility has an approved fire clearance for six (6) non-ambulatory residents of which one (1) may be bedridden. Hospice waiver approved for two (2).

The living room and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 77°F. LPA observed a fire extinguisher to be located in the kitchen and dated 02/2026. A working telephone was observed on the kitchen counter.

Kitchen: The kitchen was observed to be clean. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. Knives/sharps were observed to be kept in a locked kitchen drawer. The cleaning solutions/toxins were observed to be kept locked in an outside storage compartment. Kitchen appliances were observed to be working and in proper condition.