Facility Evaluation Report

Licensing Program Analyst (LPA) Shira Stamps met with Armenuhi Davtyan (Licensee/Applicant) for a Pre-licensing inspection at 10:20 am.

The facility has five (5) bedrooms and two (2) bathrooms designated for a capacity of six (6) residents. One (1) bedroom is designated for staff/office only and will remain locked at all times. Staff will be awake at night. The physical plant was toured inside and out at 10:45am.

LPA observed the living room and furniture to be clean and in good repair. LPA observed the dining area to be clean and in good repair. The facility maintains a comfortable temperature at 71 degrees F, which meet regulations. The air conditioner is operational. No firearms observed or will be maintained on the premises.

The dual smoke alarm and carbon monoxide detector were operational and tested at 11:15 am. Fire extinguishers appear to be full and serviced on 03/202.

Resident room s: Two (2) rooms will be shared and two (2) rooms will be private. LPA observed rooms to have bedding sheets, pillowcase, blankets, mattress pads, which are in good condition. There is at least one chair, a nightstand, and sufficient lighting for each client. The mattresses and bedsprings were also checked for condition. Window covering and window screens are in good repair for each room.

Residents will have sufficient amounts of supplies for personal hygiene products, which is provided by the Licensee.