Facility Evaluation Report

Licensing Program Analysts (LPAs) Nadia Shahbazian and Michael Cava conducted a Pre-Licensing Inspection with the applicant representative and administrator, Art and Hakop Nshanian. An Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on May 14, 2024. A fire clearance was approved on September 13, 2024 for five (5) non-ambulatory residents and one (1) bedridden resident, for a total capacity of six. The applicant will also be requesting a hospice waiver to retain six (6) residents. The smoke alarms and carbon monoxide detector are dual and inter-connected. The facility has a brand new fire extinguisher purchased on 09/13/24. Fire extinguisher is located at the kitchen. .

With the assistance of both the administrator and applicant representative, a tour of the physical plant was initiated and the following was observed:

KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, stove/oven, microwave oven and sink. There was an adequate supply of non-perishable food items observed. Perishable food items not required at this time as there are no residents. Administrator was advised facility needs to carry perishable food items once they admit residents for care. Knives were observed locked in a kitchen drawer. Cleaning supplies observed locked underneath the kitchen sink.

BEDROOMS: There are three (3) bedrooms designated for client use. All three bedrooms will be shared. One bedroom, Room #3 was used as a model room, which was furnished with two beds, 2 night stand, 2 chairs, a shared dress drawer, bedding and linen. The bedrooms have sufficient lighting. Per STD 850, all bedrooms qualify for a bedridden resident.

BATHROOMS: The facility has three (3) bathrooms. Bedroom #1 has it's own bathroom with shower. The other two bathrooms are located in the common area, by the kitchen and dining room. The bathrooms were