Facility Evaluation Report

At 10:00am Licensing Program Analyst (LPA) Perchui Milena Khurshudyan conducted an announced Pre-Licensing Inspection and met with the facility administrator Nvard Gevorkian.

An application was submitted to Community Care Licensing Division-CCLD on 01/02/2024, Initial license for a Residential Care Facility for the Elderly, 60 years and older. A fire clearance was approved on April 24, 2024 for five (5) non-ambulatory residents and one (1) bedridden resident, for a total capacity of six (6). The bedridden fire clearance is for bedrooms #1, #2, and #3. Bedrooms #4, #5, #6 cleared for non-ambulatory residents. The applicant also requested a hospice waiver and granted for two (2) residents. The facility is a single-story home.

A tour of the physical plant was initiated at approximately 10:15am and the following was observed:

KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, microwave oven and sink. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). Knives and sharps were observed to be locked in a kitchen drawer and inaccessible.

BEDROOMS: There are six (6) bedrooms designated for residents’ private use. All bedrooms are furnished and well equipped with bed, nightstand, chair, dresser, bedding, and extra linen. Rooms were observed to have sufficient lighting and closet space. Auditory alarms were tested and observed to be operational at 10:35am. Facility will have awake staff.

BATHROOMS: The facility has two (2) bathrooms, bathroom #1 designated for the residents’ use, bathroom #2 is designated for staff. Both bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured at 10:45am to be at 117°F degrees.