Facility Evaluation Report

Licensing Program Analyst (LPA) Trevor Byrne arrived to the facility at 10:30 AM to conduct an unannounced Case Management – Other inspection at the facility today. LPA met with facility staff member Keyna Nkumbula (S1) who contacted the facility Administrator Elba Khachatryan entrance interview conducted and the reason for the visit was explained. The Administrator stated that they were unable to come to the facility at the time of the visit but has designated S1 to receive this report on their behalf.

During today’s visit between 10:32 AM and 1:00 PM, LPA conducted a physical plant tour, conducted a medication audit for three (3) residents, conducted a brief file review for six (6) residents, interviewed six (6) residents, one (1) staff member, and attempted to interview one (1) guest. The following was observed.

KITCHEN: The LPA observed the kitchen area to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of two (2) days perishable and seven (7) days non-perishable food.

BEDROOMS: LPA observed three (3) resident bedrooms. All bedrooms were observed to be furnished appropriately.

BATHROOMS: LPA observed one (1) common resident bathroom. The bathroom appeared to be clean and in good repair.