Facility Evaluation Report

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 09:36 AM. LPA met with facility staff who contacted the Administrator Zhirayr Ayvazyan. The Administrator arrived to the facility at 09:55 AM. Entrance interview conducted and the reason for the visit was explained.

Beginning at 10:00 AM, the LPA, along with facility Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed:

COMMON AREAS : This included the living room, laundry closet, storage room, and dining area. LPA observed the living room to contain adequate seating and an adequately screened fireplace. LPA observed the laundry closet to contain a washer and dryer and an appropriately secured cabinet which contained cleaning/laundry chemicals. LPA observed the hallway to contain a storage cabinet which contained extra care supplies. LPA observed the dining area to be clean and properly furnished at the time of the visit. The dining room contained a dining table with adequate seating for resident use and a fire extinguisher that was fully charged and purchased on 08/23/2025. All common rooms in the facility were observed to be clean and in good repair. The facility’s combination fire and carbon monoxide alarms were tested at 02:29 PM and were functional at the time of the visit. All exits in the facility were observed to contain functioning auditory alarms.

BEDROOMS : There are three (3) bedrooms in the facility; two (2) are dual occupancy resident rooms and one (1) is a single occupancy resident room. LPA and facility administrator toured all three (3) bedrooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Bedrooms #2 & 3 contain direct exits to the outdoors of the facility. CONT. on LIC 809C.