Facility Evaluation Report

Licensing Program Analyst (LPA) Sandra Urena conducted a pre-licensing visit to the above noted facility. The LPA met with applicant, Naira Badalyan. This is an application for a new facility. A dementia program was included in the plan of operation. A Hospice Waiver has been requested and approved for six (6) residents.

At 10:15 a.m., the LPA and the applicant conducted a physical plant tour inside and out to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The facility is a one-story dwelling. An approved fire clearance was received on 07/27/2023, clearing them for four (4) non-ambulatory residents; one (1) bedridden resident, and one (1) ambulatory resident.

KITCHEN: Kitchen knives are stored in a locked box located on top of the kitchen counter. The supply of dishes, utensils, pots, pans, and drinkware is adequate. The temperatures for the refrigerator and freezer were not checked, due to thermometers missing to gauge the temperatures. The supply of nonperishable food is adequate. There are no pesticides (poisons) or toxins stored in any food storage area or preparation area with utensils. Appliances in the kitchen were clean and all appeared functional. Trash cans had tight fitting lids. Kitchen, laundry and house cleaning supplies are stored and locked in the garage area. No flies or other vermin were observed.

BEDROOMS: The facility has two (2) private residents’ bedrooms: rooms 1 and room 4; and two (2) shared room(s), room 2 and room 3. One residents’ bedroom, Room # 2 has a direct exit to the patio. The bedroom’s sliding door needs to be flushed with the floor for easy transfer from bedroom to outdoor area. Shared bedroom # 2 has been approved and cleared for one bedridden resident. Bedrooms 1, 2, 3, & 4, need a chair. All bedrooms were set up with night stands, lamps, and closet space.