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 Naira Aghajanyan, Staff. Rebeka Durgaryan, Administrator was contacted by staff and LPA Yee was advised that Laura Hovhannisyan, Designated Responsible Staff would conduct today's visit since she was on vacation. A completed LIC308 - Designation of Facility Responsibility was observed in the staff's file. Ms. Hovhannisyan arrived a little later to conduct the visit. The reason for today's visit was provided.

The home is a single storey family home consisting of 5 bedrooms, 3 full bathrooms of which one is designated for staff use, a living room, dining room, a den, office and a kitchen. All five bedrooms are now used by residents. The facility is fire cleared for 1 BEDRIDDEN and 5 NON-AMBULATORY residents. Bedroom #2, located in the back right hand corner, is designated for Bedridden use

On today's visit, LPA Yee reviewed 6 resident files, 7 staff files, and completed the following 2 domains of the CARE Inspection Tool 1. Infection Control and Personnel Records/Staff Training. A quick tour of the 5 residents rooms was conducted to verify the use of each room due to changes observed from previous visits conducted to the facility. Bedroom #5, by the front door was formerly designated for Staff use was observed with 1 resident and Bedroom #4, directly by the dining room was formerly used for storage was observed with 1 resident in a hospital bed with full bed rails. Bedroom #3 has 2 beds with 2 residents, Bedroom #2 was observed with 2 beds and Bedroom #1 was observed with 2 beds and 1 resident. A total of 8 beds were observed and the facility is licensed for a capacity of 6. The facility may only have beds for the capacity