Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 10:00 a.m., the LPA met with staff and explained the reason for it visit. At 10:20 a.m., Administrator Arpine Mkrtchyan arrived at the facility.

RECORD REVIEW: Between 10:15 a.m. and 11:26 a.m., the LPA conducted a file review for all four (4) residents and staff regularly scheduled and observed the following: Staff have current first aid and training documentation. Resident records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All files were in order. The Administrator’s Certificate is valid until 10/13/2025. The last fire drill took place on 07/01/2025. The LPA observed documentation of the Infection Control Plan and Emergency and Disaster Plan.

At 10:54 a.m., the LPA conducted a review of medication and medication documentation with the Administrator for two (2) out of four (4) residents and observed that medications were properly documented and assisted as prescribed. Medications are locked and centrally stored in a filing cabinet inside the kitchen.

At 12:40 p.m., the LPA, along with the Administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards.

KITCHEN: The LPA observed the kitchen and dining area. Knives are stored in a locked drawer. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 12:49 p.m., hot water measured at 115.5-degree Fahrenheit. Continued on LIC-809-C.