Facility Evaluation Report

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 9:20AM. The LPA met with Staff #1 (S1) and Staff #2 (S2) and explained the reason for the visit. S1 contacted Administrator Aleksandra Vartapetova who was unavailable and designated S1 to conduct the visit and sign today’s report. Entrance interview conducted.

Beginning at 9:33AM, the LPA and S1 toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and facility is in compliance with Title 22 Regulations. The facility is a single story residential home. The following was observed:

COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The dining room had a screened and inoperable fireplace. Required postings were located on the entryway wall. The entryway hallway had two (2) closets: one (1) was locked and contained resident medications and one (1) closet contained files and storage. The facility maintained a comfortable temperature throughout the visit. The facility had a laundry room connected to the kitchen and LPA observed the machines to be in good condition.

KITCHEN: The LPA observed knives stored inaccessible in a locked drawer. Additional knives and scissors were observed in unsecured drawers and S1 secured them. Cleaning supplies were stored inaccessible and locked under the sink. Kitchen appliances were clean and in operable condition.