Facility Evaluation Report

Licensing Program Analyst (LPA) Zabel Chochian arrived unannounced to conduct a required annual visit. The LPA was greeted by staff. Introductions conducted and reason for visit was stated. Staff contacted the facility representative Alexsandra Vartapetova who arrived shortly thereafter.

At approximately 12:30pm, LPA and the administrator conducted a tour of the inside, and outside of the facility to ensure there are no health and safety hazards, and the facility is in compliance with Title 22 Regulations. Smoke and Carbon monoxide detector observed operable during todays visit.

COMMON AREAS: The living room and dining room walls and flooring were checked for cleanliness and were observed to be in good condition. Furniture was observed to be clean, appropriate, and in good condition. Room temperature was recorded at 78 degrees Fahrenheit. Required postings observed on the main entrance hallway wall.

BEDROOM: The facility has six bedrooms with single occupancy, each bedroom has a private bathroom. Bedrooms were furnished appropriately with appropriate furnishings, bed linens, and sufficient lighting. Full rail observed on resident #5 Resident #5 is not on hospice at this time. BATHROOMS: Each of the six (6) bathrooms were observed to be clean; shower area was in clean condition with grab bars and a non-skid mat available. Towels for each resident were available for drying hands. Sufficient amount of hand soap, and paper products observed in each restroom. There were enough linens and towels for all residents.

KITCHEN: The appliances were observed to be in operable condition. The facility has enough supply of perishable and non-perishable food. Freezer and refrigerator are stocked with a variety of foods. Supply of emergency food observed in the pantry which is good for current residents and staff. Fire extinguisher observed in the kitchen (10/2025). Kitchen knives were stored inaccessible to residents in care.