Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted an announced visit and met with Administrator Nvard Gevorkian for the purpose of conducting an Initial Pre-Licensing Inspection / Component III visit.

The facility has an approved fire clearance to be licensed to serve 6 Non-Ambulatory Residents, of which 1 may be bedridden. All bedrooms are approved for bedridden.

Facility is a single-story home located in Monrovia, Ca and includes the following: 6 Bedrooms, 2 full bathrooms (one located in garage and will be used by staff only), 1 half-bathroom, living room, kitchen, dining area, 3 locked outdoor storage areas, detached garage, and a back yard with shaded outdoor patio area.

LPA toured facility inside and out alongside Administrator Nvard Gevorkian,

The Pre-Licensing Inspection Tool was utilized and the following was observed:

There is a locked cabinet that is centrally located for medication within the kitchen area of the facility.

Cleaning supplies are kept separate from food and located in a locked cabinet under the kitchen sink.

Facility walls, ceilings, floors, window screens and areas around the facility are clean and in good repair.

Fire extinguishers and smoke detectors operate properly.

Doors and passageways are free of obstruction.

There are no pools/bodies of water at the facility.

Facility does not have firearms on premises.

Facility sketch and sample menus were posted and visible within the facility.