Facility Evaluation Report

Licensing Program Analyst (LPA) Sandra Urena arrived at the facility unannounced to conduct a Case Management Annual Continuation Inspection. At 10:10 a.m. LPA Urena arrived at the facility and rang the doorbell several times, however, there was no response. The LPA called the Administrator, Armenui Simityan and informed them the reason for the visit. The Administrator stated that they do not have any staff or residents at the current time, and that it would take her about 30 minutes to get to the facility. The LPA stated that they would wait for Administrator to arrive.

At 11:15 a.m., the LPA, along with the Administrator, 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.

COMMON AREAS: The LPA observed common areas to be relatively clean and properly furnished. The LPA observed the fire extinguisher to be purchased 01/14/2026. The fire alarms/carbon monoxide detectors were tested and functioned properly. All exits have functioning auditory devices and were operational at the time of the visit. Facility telephone was observed during the time of the visit. Medications and first aid kits are located in a locked storage cabinet located in the hallway leading to bedrooms #4 and #3.

KITCHEN: Knives are stored in a locked kitchen cabinet. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Laundry units are located next to the kitchen. Cleaning solutions and chemical items were inaccessible and locked away inside cabinets in the laundry area. Continues on LIC 809C...