Facility Evaluation Report

Licensing Program Analyst (LPA) Sandra Urena conducted a Pre-licensing visit and met with the applicant Viktorya Hayrapetyan. This is a new facility application for a Residential Facility for the Elderly (RCFE ) for six (6) non-ambulatory residents, no bedridden residents can be admitted. Fire Clearance was approved on 05/13/2024 for all rooms for non-ambulatory use.

At 11:15 a.m., the LPA, and the applicant toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility is in compliance with Title 22 Regulations.

KITCHEN: Kitchen knives are stored locked and inaccessible in a locked kitchen drawer. A seven-day supply of non-perishable food was available. The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen cleaning supplies will be stored and locked under the kitchen sink. Hot water temperature was recorded at 118.1 degrees Fahrenheit. Trash cans have a tight-fitting lid. There were no pesticides or toxins stored near food, or preparation area. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. A fire extinguisher is located near the backdoor exit, which was purchased on 04/19/2024.

BEDROOMS: There are three (3) bedrooms for residents in care. Rooms 1, 2 and 3 will be a shared rooms; all bedrooms are cleared for non-ambulatory. All bedrooms were supplied with all required bedding and linens. There is sufficient lighting as well as closet and drawer space available. Bedrooms (1 and 2) closets will have a divider installed to separate residents clothing. Bedroom 3 closet will be cleared of items (wheelchairs, walkers, storage items, etc.)

BATHROOMS: There are (2) full bathrooms, with shower and bathtubs, and one (1) restroom. Bathrooms are equipped with toilets and shower grab bars, and non-skid mats. There are sufficient supplies of towels, paper goods and personal hygiene supplies. Hot water delivered was between 117.6 to 119.1 degrees Fahrenheit. Continues on LIC 809C...