Facility Evaluation Report

At 9:00 AM Licensing Program Analyst (LPA), Huma Rahimi, conducted an unannounced annual inspection at the facility mentioned above. LPA met with staff, Mariam Arzumanyan and later Administrator, Khatchik Danielian, arrived and LPA explained the reason for the visit. Physical tour was conducted with the Administrator and LPA observed the following:

The facility is a single storey building and has three (3) bedrooms for residents use, one (1) office, and two (2) bathrooms. Fire cleared for six (6) non-ambulatory residents, one (1) of which maybe bedridden on Room #1. Hospice waiver for six (6) residents.

Kitchen: At approximately, 9:30 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. Knives and sharps are observed to be locked in the kitchen drawer and inaccessible to residents. Toxins and cleaning solutions were locked under the sink.

Medications: LPA observed that the medication are kept in the filing cabinet inside the office and was observed to be locked and inaccessible to residents in care, however, review of R1's random medication revealed that the facility was supposed to start Lisinopril (Blood Pressure Medication) a new bottle on 03/03/2024. During today's visit LPA counted R1's medication and it was discovered that there was a discrepancy and six (6) extra pills were in the bottle. LPA asked the Administrator and the staff for explaining and both staff could not provide any answers. LPA also observed Centrally Stored Medication (LIC 622) records and did not observe staff filling the box when the medication start date. A deficiency will be cited. There was a complete first aid kit located on top of the medication cabinet in the office.

Bedrooms: LPA observed total of three (3) bedrooms designated for residents use. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Facility has an awake staff.