Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection. Upon arrival at the location, LPA Yee made contact with the home via the telephone number provided in the facility profile and was informed by Andranik Khachatrian, Corporate Officer that the facility doses not have any residents. LPA Yee explained that an annual inspection is still needed. Kachik Rumelyan, Administrator, was contacted and he arrived at 10:32am to conduct the visit. The reason for today's visit was provided.

The home is a single storey family home consisting of a living room, dining room, kitchen, 4 bedrooms, 3 full bathrooms and a attached garage. Located in the back is a ADU with an address of 6702 Ben Avenue and is not part of the facility operations. The facility is fire cleared for 5 non-ambulatory residents and 1 bedridden resident. Bedroom #1 is fire cleared for bedridden use. The home is approved for 6 hospice waivers.

On today's visit, LPA Yee conducted a tour or the facility inside and outside to observe the physical plant. The CARE Inspection Tool was not used to conduct the annual inspection today since the facility does not have any residents or staff and there are no files to review.

Per tour of the facility, the following were observed:

all the required furniture, fixtures and linens were observed in the living room, dining room, kitchen and bedrooms as it was during the Prelicensing visit.

The fire place in the living room is capped off and made inaccessible by a fire screen.

Bed linens were on the beds and extras observed in the linen closet.