Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Tan met administrator Daniel Alexandryan for a One (1) Year Required visit for this facility. LPA observed that all six (6) residents were at the facility during the visit.

A tour of the physical plant was conducted at 3:18 PM and the following was noted:

There is only one entrance being utilized at the facility, there is a required poster posted at the main door. The screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Infection Control and Mitigation plan.

The facility has a total of five (5) bedrooms and three (3) bathrooms. One bedroom is located in the converted garage that is designated for staff use only. Another bedroom is designated for staff use. One (1) bathroom is designated for staff use only. The facility is fire cleared for six (6) non-ambulatory residents, one (1) of which may be bedridden. Hospice waiver for six (6) residents.

Living and dining room furniture were also checked. Dual smoke/carbon monoxide detectors are hardwired and interconnected and observed to be operational. The fire extinguisher is located in the kitchen and observed to be full and last purchased on 04/30/25.

The backyard of the facility has outdoor furniture, with a covered shaded area for clients. There is no body of water in the facility.