Facility Evaluation Report

On 6/02/26, 8:30AM Licensing Program Analyst (LPA) Raymond Comer conducted an unannounced annual visit to this facility. LPA met with the Assistant Administrator, Girgor Kosoyan, and reason for the visit was discussed.

Facility is licensed as a single-story residence; fire clearance is licensed for six (6) total residents. One (1) resident may be non-ambulatory, and one (1) resident may be bedridden in bedroom# 3. Facility has a total of three (3) bedrooms, and two (2) bathrooms for residents’ use.

At 8:45AM , 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. Visitor Sign-in sheet, hand sanitizer, gloves and masks are available. Hand washing, coughing etiquette, and other necessary signage are posted throughout the facility. Room temperature is comfortable; wall thermostat displays a setting of 74.0°F. within the required range. Required postings are prominently displayed and observed to be current. Passageways and entrance were clear of obstruction. Disaster drills were last conducted on 3/15/2026.