Facility Evaluation Report

Licensing Program Analyst (LPA) Gary Tan conducted a Pre-Licensing Inspection with the applicant representative Nazeli Khechoyan. The applicant is "MIaMon Assistant Living". A fire clearance was approved on 11/14/24 for six (6) non-ambulatory residents, one (1) of which may be bedridden on Room #2. The facility has a total of four (4) bedrooms and two (2) bathrooms.

A tour of the physical plant was initiated at approximately 9:26 AM and the following was observed:

KITCHEN: The facility has a Kitchen that is equipped with a refrigerator, microwave, stove, dishwasher and sink. There was an adequate supply of perishable and nonperishable food. Knives were observed locked in a kitchen drawer. Cleaning supplies and other toxins will be stored in the cabinet in the garage which was locked during visit.

BEDROOMS: There are four (4) bedrooms designated for client's use; two (2) private and two (2) shared. The applicant furnished the resident bedrooms with beds, night stand, chairs, dressers, bedding and linen. The bedrooms have sufficient lighting and storage.

BATHROOMS: The facility has two (2) shared bathrooms for clients' use. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water temperature was measured at a range of 117.9°F to 118.4°F.

LAUNDRY ROOM: The laundry area is located in the garage. Laundry detergents and other cleaning agents were locked in a cabinet inside the garage. The garage was observed to be locked during visit. (continued on LIC 809-C)