Facility Evaluation Report

On 10/15/24, at 10:28am, Licensing Program Analyst, (LPA) Raymond Comer, arrived to conduct an unannounced annual visit of the facility. LPA met with Facility Administrator, Narine Mamyan, and reason for the visit was disclosed.

Facility is licensed as a single-story residence; fire clearance is licensed for six (6) non-ambulatory residents; ages 60 and older. Two (2) residents may be bedridden; hospice waiver is for four (4) residents. Facility has four (4) bedrooms, and two (2) bathrooms.

At 10:45am , LPA conducted a tour of the physical plant with the Administrator, and observed the following:

Physical plant was inspected for cleanliness and condition. Facility’s main door is the primary entry/exit access point. Emergency exits are at the rear of the living room area, and at each bedroom.

Visitor Sign-in sheet, hand sanitizer, gloves and masks are available. Covid 19 prevention protocols are posted. Hand washing, coughing etiquette, and other necessary signage is posted throughout the facility. Room temperature is comfortable; wall thermostat displays a setting of 73.0°F ; within the required range.

Required postings are prominently displayed and observed to be current. Disaster drills were last conducted on 7/22/2024.

Fire Detection system is present. Dual smoke-carbon monoxide detectors are located throughout the facility. Detectors were tested and function properly. LPA observed one fire extinguisher hanging on the wall in the kitchen area; last service date was 7/15/2 4 .