Facility Evaluation Report

Licensing Program Analyst (LPA Yee) conducted an unannounced case management visit due to deficiencies noted on a visit to the facility today. LPA Yee met with Mariam Baghdoyan, Caregiver. Also present during the visit was Emilya Hovsepyan, Caregiver. The Administrator was unreachable during today's visit. The reason for today's visit was explained.

During today's visit, staff attempted to contact the Administrator/Licensee, Asmik Nadrian via telephone and she was unreachable. The following deficiencies were observed:

Staff files were reviewed and there was no completed LIC308 - Designation of Facility Responsibility observed in file for the 2 staff present at the facility to provide coverage when the Administrator is not present at the facility. A completed LIC308 was observed in for Marine Arshakyan but she was not present at the facility today until 1:20pm.

LPA Yee requested Mariam Baghdoyan's file and was not able to be located or produced for review until 2:52pm and it was incomplete. It contained the LIC508-Criminal Record Statement, LIC9182 Criminal Background Clearance Transfer, LIC503-Health Screening Report - Facility Personnel with no evidence of a TB Test and a Applicant Fingerprint Response.

Deficiencies cited under California Code of Regulations Title 22, Division 6, Chapter 8.

Exit interview was conducted With Marina Arshakyan, Appeals Rights discussed and a copy was given