Facility Evaluation Report

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA met with staff, Seolrock and Knarik Vardanyan, and explained the reason for the visit. Seolrock is not associated or fingerprinted to be at the facility. Deficiency will be cited in LIC 9099-D. Approximately, around 1:20 PM staff designee, Ovsanna Khayalya, arrived and was explained for the reason of the visit.

At 1:30 PM, with the assistance of of staff designee, LPA took a tour of the physical plant. Required postings were observed in the entry area. At 1:59 PM smoke alarms were tested and are operational. There are carbon monoxide detectors that functions properly. The fire extinguisher is beside the kitchen. During the visit the facility is at 72 degrees Fahrenheit. The facility is fire cleared for six (06) residents of which two (2) ambulatory; three (3) non-ambulatory, one (1) bedridden resident in bedroom #2. Approve for four (4) hospice waiver.

Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. LPA observe R2 in refrigerator unlock and accessible to residents in the facility. Deficiency will be cited in LIC 9099-D.

Bedrooms: There were five (5) bedrooms designated for clients' and staff use. Four (4) of the that are in use by residents were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Room #1, bedroom #2, and bedroom #4 are properly furnished and is for private used. Room #3 is shared. Bedroom #5 is for staff use. Staff bedrooms are locked with no medication in sight.