Facility Evaluation Report

On 1/11/2022, Licensing Program Analyst (LPA) Melissa Ruiz conducted an announced Pre-Licensing visit to this facility and met with applicant Peter Atoyan. This is a Change of Ownership Application. A fire Clearance dated 12/21/2022 was received for six (6) residents, of which five (5) could be non-ambulatory residents, and one (1) bedridden in Room #4. Facility has a hospice waiver for four (4) residents. The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6.

Today’s site visit consisted of LPA touring the physical plant inside and outside and observed the following:

Facility has a fire extinguisher, with a date of purchase of 3/16/22. There is a functioning telephone on the premises. Emergency exit plan/sketch is posted on the living room wall with other posting requirements. There are (4) resident bedrooms. Resident bedrooms were observed to be appropriately furnished. The common areas (living room, kitchen and dining areas) were appropriately furnished, and lighting was adequate. The living room has a television and comfortable furniture. Resident and staff records are stored in a locked cabinet in the living area. Medications are centrally stored in a locked file cabinet. The first aid kit is readily available. There are three (3) bathrooms in the facility. One (1) bathroom is designated for staff use only and the two (2) common bathrooms have non-skid mats and appropriate grab bars. Trash cans were observed to have closed tight fitting lids.