Facility Evaluation Report

Licensing Program Analyst (LPA), Salia Walker conducted a pre-licensing inspection to this property at 8:30 a.m. on April 6, 2022, and met with applicant representative Rebeka Durgaryan. The applicant has obtained fire clearance for five (5) non-ambulatory residents, and one (1) bedridden resident for a total capacity of six (6) clients. Fire clearance indicates ‘Bedroom #1 allowed bedridden patient.’

The LPA inspected the facility for Fire Safety, Personal Accommodations and Services, and Food Service. At 9:24 a.m., all hard-wired smoke alarms and carbon monoxide detectors were tested and function properly. The LPA observed two (2) fire extinguishers to be fully charged with a purchase date of 05/05/2021.

There are three (3) double occupancy bedrooms for resident use. One (1) out of three (3) resident bedrooms have a private bathroom. There are no staff bedrooms in the facility. Each bedroom is equipped with clean mattresses, pillows and bedding. There is sufficient supply of linens, including blankets, bath towels and wash cloths. Bedrooms have sufficient lighting. The facility has one (1) common bathroom for resident use. All common and private bathrooms contain appropriate non-skid mats and grab bars. Bathrooms have sufficient paper products. Night-lights were present in the main hallway. Between 9:05 a.m. and 9:07 a.m., hot water temperatures measured between 109.5 and 116.9 degrees Fahrenheit in the common and private bathroom(s).

The LPA toured the kitchen area at 8:58 a.m. The facility has a sufficient (7) day supply of perishable and non-perishable food. Appliances and all equipment appear to be clean and in good repair. Kitchen knives are stored in a locked cabinet. The kitchen has a sufficient supply of plates, cups, cook ware and utensils. Hot water measured at 112.8 degrees Fahrenheit at 9:34 a.m.