Facility Evaluation Report

Licensing Program Analyst (LPA) Zabel Chochian conducted a required annual visit at this facility. Upon arrival LPA met with staff and reason for the visit was explained. Administrator Irina Petrosyan was called and arrived to the facility.

At approximately 2:15 p.m., a physical plant tour was conducted inside and outside with staff. The facility is one story. The facility has four (4) bedrooms which are designated for residents only. There are no staff rooms therefore, ‘awake night staff is required. There are two (2) bathrooms in the facility, and one (1) bathroom located outside in the laundry room is designated for staff. BEDROOMS: Resident bedrooms observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting.

RESTROOMS: There are three (3) restrooms of which one (1) is located in the hallway; resident room and laundry room for staff use only. Resident restrooms observed clean, sanitary, and in operating condition with grab bars and slip-resistant surfaces. Hot water temperatures were measured in restrooms and were between 110.6-115.9 degrees F, which is within the required range. COMMON AREAS: LPA observed living room and dining area to be clean and properly furnished. KITCHEN: LPA observed the kitchen/dining area. Knives are stored in a locked kitchen drawer. Kitchen appliances observed in operable condition; the facility has a sufficient supply of two-day perishable and seven-day non-perishable food. Fire extinguisher observed fully charged with receipt purchased on 4/30/2026. Smoke and carbon monoxide detectors were tested and functioned properly. Night lights were present in the hallways and passages. All exits have functioning auditory devices. LPA observed required postings throughout the common spaces. LAUNDRY/STORAGE ROOM: Washer, dryer, and laundry supplies were observed inside the locked laundry/storage room. OUTDOOR SPACE/GARAGE: LPA observed the front patio which has a covered area for resident use. Passageways were free and clear from obstruction. (Continue to LIC809c).