Facility Evaluation Report

At 12:30 PM, Licensing Program Analyst (LPA) Huma Rahimi, conducted an unannounced annual inspection at the facility mentioned above. LPA met with the Administrator Maryam Harutyunyan and explained the reason for the visit. Physical tour was conducted with the Administrator and LPA observed the following:

KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven, sink. Stove was observed in a good working condition. LPA 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 locked box in the kitchen. LPA observed all cleaning supplies to be locked under the kitchen sink. A fire extinguisher was hanging on the kitchen wall and last serviced on 01/13/2025.

BEDROOMS: LPA observed that there are three (3) bedrooms for residents use only. Bedroom # one (1) and bedroom # two (2) are private, and bedroom # three (3) is shared. Bedroom # one (1) is cleard for a bedridden resident. LPA observed all bedrooms properly furnished with beds, dressers and required bedding, chest drawer, and linen. The bedrooms have sufficient closet space and have sufficient lighting. Facility will have a no live-in staff at the facility. LPA did not observe any obstruction or hazard.

BATHROOMS: At 12:40 PM, LPA observed two (2) bathrooms of which one (1) is for staff use and one (1) for residents use. The bathroom for residents was observed to be clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed to have appropriate grab bar and a non-skid mat. At 12:42 PM, the water temperature was noted at 117.1°.