Facility Evaluation Report

Licensing Program Analysts (LPAs) Trevor Byrne and Emily Peraldi arrived at the facility unannounced to conduct a required annual visit at 09:35 AM. LPAs met with facility staff who contacted the facility administrator Zaruhi Harutyunyan. Facility administrator arrived to the facility at 09:36 AM Entrance interview conducted and the reason for the visit was explained.

Beginning at 09:37 AM, the LPAs, along with facility administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed:

KITCHEN : The LPAs observed the kitchen area to be clean. Kitchen appliances were in operable condition. The facility has a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. LPAs observed a secured cabinet contain knives and other sharp objects. The LPAs observed the fire extinguisher to be fully charged and purchased on 06/12/2024.

BEDROOMS : There are three (3) bedrooms in the facility; all are designated for resident use, and all are designated as dual occupancy rooms. LPAs and facility administrator toured all three (3) resident rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Bedroom number one (1) is approved for a bedridden resident. Auditory alarms were observed to be functional on bedroom one’s (1’s) exit door.

BATHROOMS : There are two (2) bathrooms at the facility. One (1) is designated as a resident restroom and one (1) is primarily used as a staff restroom. Both restrooms were observed to be clean and in good repair and all were equipped with nonskid surfaces. Grab bars were observed in the resident restroom shower and by the resident toilet, all were properly secured. The water temperature was measured between 110.1 and 113 degrees Fahrenheit, which is in compliance with regulation. Report Continued on LIC 809-C