Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool and was let into the home by staff. LPA Yee met with Vahe Mkrtchian, Administrator. The reason for today's visit was provided.

The facility is a single storey family home consisting of a living room, dining room, kitchen, four bedrooms of which one is used for live-in staff, 2 full common bathrooms and a attached garage. The swimming pool previously located in the backyard has been dismantled and the hole filled in. Permits were obtained. The facility is fire cleared for four (4) NON-AMBULATORY of which one (1) may be BEDRIDDEN. Bedroom #1 is currently designated for bedridden use. The facility has a hospice waiver for 4. The facility is vendorized by the North Los Angeles County Regional Center and is a Level 3 home.

On today's visit all 12 domains of the CARE Inspection Tool was reviewed. Also reviewed were 4 resident and 5 staff files. A tour was conducted of the physical plant, inside and outside. The following was observed:

The living room, dining room and kitchen had the appropriate furnishings and kitchen equipment for the four clients.

Bedroom #1 is used as a double occupancy room and Bedroom #2 and Bedroom #3 are used as single occupancy. All 3 resident bedrooms have the required beds, chairs, night stand, lamps and closet. The required bed linens were observed. Blinds on the windows were observed.

Bedroom #4 is designated for live-in staff and was toured.

Both common bathrooms are equipped with a large walk-in shower, a toilet and a sink. Grab bars and