Facility Evaluation Report

Licensing Program Analyst(LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool and was let into the home by Mariam Baghdoyan, Staff. Staff contacted Asmik Nadrian, Administrator via telephone and LPA Yee was initially told that she was not in town. However, due to clarifications needed for the change in ownership, she arrived at 12:04pm to conduct the visit. The reason for the visit was explained.

The home is a single storey family home consisting of a living room, dining room, a kitchen, 4 resident bedrooms, 3 bathrooms and a attached garage. The home is fire cleared for 5 non-ambulatory and 1 bedridden resident. Bedroom #4 is the room designated for bedridden use.

During today's visit, LPA Yee reviewed the following domains: Infection Control, Operational Requirements, Staffing, Resident Rights/Information and Resident Records/Incident Reports. Also reviewed on today's visit were 6 resident files and 4 Staff files.

Deficiencies observed, were cited under California Code of Regulations, Title 22 Division 6, Chapter 8 and Health and Safety Code, Chapter 3.2

Due to time constraints, any deficiencies not cited on today's visit will be addressed on a return visit.

Exit interview was conducted, Appeals Rights discussed and a copy was given.