Facility Evaluation Report

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 09:49 AM. LPA met with facility administrator Armine Tagaryan. Entrance interview conducted and the reason for the visit was explained.

Beginning at 09:52 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:

KITCHEN : The LPA observed the kitchen area to be clean. Kitchen appliances were in operable condition. The facility has a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. LPA observed a secured drawer to contain knives as well as a secured cabinet located under the sink which contained cleaning supplies.

BEDROOMS : There are three (3) bedrooms in the facility; one (1) is a dual occupancy room and two (2) are single occupancy rooms. All are designated for resident use. LPA and facility administrator toured all three (3) resident rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Three (3) resident beds were observed to contain full bed rails. Auditory alarms were observed on facility exits and all were functional at the time of the visit.

BATHROOMS : There are two (2) bathrooms at the facility. Both bathrooms are designated as shared resident bathrooms. All bathrooms were observed to be clean and in good repair and all were equipped with nonskid surfaces. Grab bars were observed in all showers and near all toilets, all were properly secured. The water temperature was measured between 121.6 and 124.7 degrees Fahrenheit, which is in compliance with regulation. Report Continued on LIC 809-C