Facility Evaluation Report

At 09:30 AM, Licensing Program Analyst (LPA), Huma Rahimi conducted an announced Pre-Licensing visit to the above facility and met with Taline Bilamjian, Licensee/Administrator, and explained the reason for the visit. At the time of this visit LPA did not observe any residents present in the facility. Fire Clearance dated 05/06/2024 and received for four (4) Non-ambulatory, and one (1) Bedridden (room #3) residents. The purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22, Division 6. The facility is a single-story building. Today's site visit consisted of LPA touring the physical plant inside and outside and observed the following:

KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven, and a sink. Stove was observed in a good working condition. At 09:25am, LPA observed adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of five (5). All knives and sharps are observed to be locked in a kitchen cabinet and inaccessible to residents. Fire Extinguisher was last purchased on 04/09/2024 and was observed hanging on the wall in the kitchen.

MEDICATION ROOM: The centrally stored medication will be kept in the living room in a locked standing cabinet. All resident and staff files will be kept in the same cabinet and locked.

BEDROOMS: There are three (3) bedrooms designated for resident’s use. Bedrooms number one (1) and two (2) are shared. Bedroom (3) is used for a bedridden resident. All bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. Auditory alarms were tested and observed to be operational. Facility will have a no live-in staff at the facility; however, the staff will live in the main house next door.