Facility Evaluation Report

At 09:00 AM, Licensing Program Analyst (LPA) Huma Rahimi, conducted an unannounced annual visit. LPA met with staff, Hasmik Mandlyan,and the staff contacted the Administrator. LPA explained the reason for the visit. The Administrator arrived at 9:30 AM. The physical plant tour was conducted and LPA observed the following:

The facility is a single story building with four (4) bedrooms, two (2) bathrooms, kitchen, common areas, and outdoor areas. It has an approved fire clearance for six (6) nonambulatiory residents, of which one (1) may be bedridden in Bedroom # one (1). The facility serves residents with dementia. Approved hospice waivers for six (6). The facility uses surveillance cameras on the interior and exterior.

Kitchen: At approximately, 9:35 AM LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps observed to be locked in a kitchen cabinet. A fully charged fire extinguisher hung near the kitchen purchased on 03/01/2025.

Laundry Room : At 9:40 AM, LPA observed that the cleaning solutions were locked in the laundry room, located next to the kitchen. A washer and dryer in good condition and LPA observed both were running washing and drying cloths.

Medications: At approximately, 9:42 AM LPA observed medications are centrally stored and were locked near the dining room cabinet.

Bedrooms: The facility has four (4) bedrooms. Two (2) are private and two (2) are shared. All bedrooms contained a nightstand, storage, and bed with adequate bedding. All furnishings were clean and in good condition. Bedroom four (4) is vacant.