Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Tan conducted an announced Pre-Licensing Inspection with the applicant representative and administrator Hermine Nshanian. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 09/24/24. A fire clearance was approved on 03/31/25 for six (6) non-ambulatory residents, all of which maybe bedridden. 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 located by the dining area and purchased on 03/16/25.

At 9:47 AM, with the assistance of the administrator and applicant representative, a tour of the physical plant was in 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 cabinet. Cleaning supplies observed locked underneath the kitchen sink.

BEDROOMS: There are three (3) bedrooms designated for client use. All three (3 bedrooms will be shared. The bedrooms were observed to have appropriate furniture and sufficient lighting.