Facility Evaluation Report

Licensing Program Analyst (LPA), Sandra Urena arrived at the facility at 11:25 a.m., and met with Applicant Rebeka Durgaryan. This is an application for a Change of Ownership(CHOW). Facility has capacity for a total of six (6) non-ambulatory residents. Fire Clearance was approved on 01/20/2023 for six (6) non-ambulatory residents only.

The facility has five bedrooms and three bathrooms. Three bedrooms will be shared rooms for residents. One bedroom will be used for an office and one bedroom will be used as a staff room.

At 11:45 a.m. the LPA, and the Applicant toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and facility is in compliance with Title 22 Regulations.

KITCHEN: A seven-day supply of non-perishable food was available. The supply of dishes is adequate.

Appliances in the kitchen were clean and all appeared functional. House cleaning supplies will be stored in locked cabinet in the laundry room. At 12:07 p.m. the hot water temperature was recorded at 112.2 Fahrenheit degrees. Knives are locked in a safety box found on top of the kitchen counter.

BEDROOMS: Facility has five (5) bedrooms total. Three (3) bedrooms will be utilized for shared resident use. One bedroom will be used for an office, and one bedroom will be used as a staff room. Lighting in the rooms appeared adequate. All bedrooms had adequate closet and drawer space for clothing and personal belongings. Bedrooms are equipped with televisions. At 12:12 p.m. the LPA and Applicant observed one television in bedroom #1, which sits on top of a cabinet drawer, and another television mounted on the wall. The TV on top of the cabinet drawer needs to be secured to wall or cabinet drawer.