Facility Evaluation Report

The pre-licensing visit was conducted by Licensing Program Analyst (LPA), Sandra Urena. The LPA arrived

at the facility at 9:30 a.m., and met with applicant Zaruhi Harutyunyan. This is a new facility application for five non-ambulatory residents, and one bedridden resident.

At 9:45 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 that the facility is in compliance with Title 22 Regulations.

KITCHEN: The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen, and house cleaning supplies will be stored in locked cabinet under the kitchen sink. Hot water temperature was recorded at 108.8 degrees Fahrenheit. Trash cans have a tight-fitting lid. There were no pesticides or toxins stored near food, or preparation area.

BEDROOMS: There are three bedrooms for residents' use, each room has double occupancy. Bedroom #1 is licensed for one bedridden resident, and one non-ambulatory resident. Bedrooms #2 and #3 are for double occupancy. Lighting in the rooms appeared adequate. All bedrooms had adequate closet, and drawer space for clothing, and personal belongings.