Facility Evaluation Report

Licensing Program Analysts (LPAs) Leslie Ngo-Castaneda, Gina Saucedo and Huma Rahimi conducted an announced pre-licensing visit at 10:00 AM and met with the licensee Vladsilav Blitshteyn and administrator Luiza Yengibaryan. In addition to the pre-Licensing inspection, a component III power point presentation was also held. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on August 1, 2023. LPAs observed that no residents during the inspection.

A tour of the physical plant was initiated at approximately 11:25am and the following was observed:

With the assistance of the licensee and administrator, LPAs conducted a facility tour of both the inside and outside. This is a single-story property. The facility is a one-story building with seven (7) bedrooms and three (3) bathrooms. A fire clearance was approved on September 13, 2023, for six (6) non-ambulatory. One (1) can be used as ambulatory and one (1) bedridden for a total capacity of six (6) residents. The applicant is also requesting a hospice waiver to retain five (5) residents. All residents’ bedrooms were adequately furnished. The facility has a designated a live-in staff restroom and staff bedroom. Resident bathrooms have properly installed grab bars and shower has non-skid flooring. Hot water temperature for bathroom # 1 between room # 4 and 5 measured at 118.1ºF, and bathroom # 2 between room # 2 and #3 measured at 114.4 ºF during the visit. The facility has an adequate temperate of 73 ºF and 75 ºF.

The common areas were appropriately furnished these included the living and dining room area. The living room was equipped with couch, non-audible camera, a television, tables and chairs. The LPAs observed entertainment equipment and games for activities. The facility has a kitchen area that is equipped with a non-audible camera, refrigerator, microwave oven, and sink. The dining table is large enough to seat six (6) individuals.