Facility Evaluation Report

Licensing Program Analysts (LPAs) Joscelyn Martinez and Shira Stamps met with Eduard Hakobyn(Licensee/Applicant) for a Pre-licensing inspection at 10:00 A.M. This is a new licensee who will be operating a capacity of six (6) Residential Facility Care for the Elderly. The facility is a single story house and has four (4) bedrooms and two (2) bathrooms of which all bedrooms will be used for residents and two (2) bathrooms will be used for residents. Bathroom adjacent to room four (4) will be used for staff use.

The physical plant was toured inside and out at 10:10 am.

Common Area: LPAs observed the living room furniture to be clean and in good repair. LPAs observed the dining area to be clean and in good repair. The facility maintains a comfortable temperature at 69 degrees F, which meet regulations. The air conditioner is operational. No firearms observed or will be maintained on the premises.

Files will be kept confidentially stored in a locked cabinet located in the staff/office room and supplied to licensing staff upon request.

Resident room s: Two (2) rooms will be shared and two (2) rooms will be private. LPAs observed rooms to have bedding sheets, pillowcase, blankets, which are in good condition. LPAs advise Administrator to purchase mattress pads. There is at least one chair, a nightstand, and sufficient lighting for each client. The mattresses and bedsprings were also checked for condition. Trash cans were observed not having tight fitting lids.

Window screens are in good repair but there are no window coverings. LPAs advised Administrator to purchase window covering that are non-see through.

Bathrooms: LPAs toured resident bathrooms and checked to make sure bathrooms were clean and in good repair. The hot water temperature measured within regulations at 115.6 degrees F. The showers have non-slip bathmats and grab bars. Trash cans with lids were in the restroom to protect consumers from cross contamination. Towels and washcloths will not be shared.