Facility Evaluation Report

Licensing Program Analyst (LPA), Mayra Cota, conducted an unannounced required annual visit today. LPA met with Sako Manvelyan, Administrator, and the reason for the visit was explained.

The facility is licensed to serve (6) non-ambulatory residents over the age of 60, of which (1) may be bedridden, with a hospice waiver for (4). The facility is a two-story home located in a residential neighborhood of Pasadena. The facility consists of a living/dining room area, a kitchen, (4) resident bedrooms, (4) resident bathrooms, (1) staff/visitor's bathroom, a basement with a laundry area, a staff resting room and office on the second floor, a front porch, a backyard, and a detached garage.

During today's visit, the following was observed:

The facility is clean inside and out. All passageways, walkways, exits and ramps are free of debris and obstructions. There are no pools or large bodies of water. Living room and dining area have sufficient seating for residents, and the furniture is in good repair. Exit doors are equipped with safety chimes and were observed to be working properly. Kitchen was observed clean and refrigerator, range and small appliances are operable and in good repair. There is sufficient food for at least 2 days of perishables and 7 days of non-perishables. Cleaning supplies, sharps and medications are kept locked in kitchen cabinets. Four (4) resident bedrooms were observed and have sufficient lighting, the required furniture, and bedding supplies. The (4) bathrooms were inspected and have grab bars and anti-skid mats. Water temperature was tested in each bathroom and measured between 109.2-117.4 degrees F., which is within the required 105-120 degrees F. Carbon monoxide and interconnected smoke detectors were tested and found to be operating appropriately. Laundry appliances were observed and are kept in good repair. Fire extinguishers were observed throughout the facility and are kept charged and operable. All required posters and signage were observed. Facility has a porch that provides a shaded area. Backyard is clean and garden is well maintained. The garage is kept clean and free of clutter.