Facility Evaluation Report

Licensing Program Analyst (LPAs) Nadia Shahbazian conducted a Pre-Licensing Inspection with the Moe Saki/Licensee and Arusyak Ohanyan/Administrator. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on December 02, 2024. A fire clearance was approved on January 21, 2025 for six (6) non-ambulatory residents, one (1) of whom may be a bedridden resident. Bedroom #2 is approved for the bedridden resident. The applicant will also be requesting a hospice waiver to retain five (5) residents.

With the assistance of the administrator, a tour of the physical plant was initiated at 10:40 and the following was observed:

The smoke alarms and carbon monoxide detectors are dual and inter-connected. LPA observed the detectors in each room. At 11:08am smoke and carbon monoxide detectors were tested and were observed to function properly. The facility has a brand new fire extinguisher purchased on 12/15/24. Fire extinguisher is located by the kitchen exit door. There is a ramp at the front entry and there are several exit doors which lead to the side yard. There is one (1) exit door in the kitchen, two (2) in the dining room and two (2) exits doors in the living room. The living room exit doors will be used as the main exit during emergencies.

COMMON AREAS: LPA observed television, games and activities in the living room. The living room has couches, telephone/cable/internet and television. The dining area has a large dining room table and chairs to accommodate six (6) residents.

OFFICE/STAFF WORKSTATION: Located by the dining room. Staff and resident files will be maintained in locked cabinets.

MEDICATIONS: The medications will be kept locked in the Office/Staff workstation. LPA observed a complete First Aid Kit and the First Aid Manual in the office workstation.