Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced annual inspection visit. The purpose of the visit was explained to Indira Balladares. Administrator Anna Khachatryan arrived later. The facility serves elderly residents ages 60 and older.

Infection Control: The Infection Control Plan was reviewed and includes environmental cleaning and disinfection activities. Facility has sufficient Personal Protective Equipment.

Operational Requirements: A Dementia and hospice waiver for 6 residents has been approved. A fire clearance for 6 non-ambulatory adults 60 and over; of which one (1) may be bedridden in room 4. Facility does not handle resident P & I monies. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 5/30/2025.

Physical Plant/Environment Safety: The facility is a single-story home located in a residential area consisting of six (6) bedrooms, two (2) full bathrooms, kitchen, dining room, living room, laundry room, rear shaded patio area, and attached garage. Front yard is landscaped with grass and back yard is landscaped with gravel. Exit doors are free of any obstruction and there are no pools or large bodies of water. Smoke and carbon monoxide detectors were tested and are operational. The facility two (2) fire extinguishers. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and Manual. Cleaning supplies, knives, and toxic substances are inaccessible to residents. The last Emergency Disaster drill was conducted on 3/29/2025.

Room #5's bedroom door is in disrepair. The bottom of the door and bottom door casing has damage caused by wheelchair.

Staffing: A total 10 staff members provide care and supervision to the clients.