Facility Evaluation Report

On 4/16/26, 9:45 am, Licensing Program Analyst (LPA) Raymond Comer conducted an unannounced annual visit to this facility. LPA met with Facility Administrator, Shake Nilkoghosyan, and reason for the visit was discussed.

Facility is licensed as a single-story residence; fire clearance is licensed for five (5) non-ambulatory, and one (1) bedridden; total capacity of six (6) residents. Facility has six total (6) bedrooms, (Bedroom#3 can be used for bedridden) and four (4) total bathrooms; two (2) bathrooms used for residents, and two (2) for visitors/staff use.

At 10:10 am , LPA conducted a tour of the physical plant with the Administrator and observed the following:

Physical plant: was inspected for cleanliness and conditio n . Facility’s main door is the primary entry/exit access. Visitor Sign-in sheet, hand sanitizer, gloves and masks are available. Hand washing, coughing etiquette, and other necessary signage are posted throughout the facility. Room temperature is comfortable; wall thermostat displays a setting of 71.0°F . , within the required range. Postings are prominently displayed and observed as current. Passageways and entrance was clear of obstruction. All entry and exit doors utilize a functional auditory alert signaling when doors are opened. Disaster drills were last conducted on 3/15/2026.

Fire detection system: is present in the facility. Dual smoke\carbon monoxide detectors are wired and interconnected throughout the facility; detectors were tested and functioned properly. LPA observed one (1) fire extinguisher located in the kitchen area; purchase/service Date: 1/13/2026.