Facility Evaluation Report

Licensing Program Analysts (LPAs) Martha Arroyo and Brian Balisi conducted an unannounced case management visit - other to ensure the health and safety of the residents in care. Upon arrival, the LPAs met with staff and explained the reason for the visit. LPA Balisi contacted Licensee Sarkis Dovlatyan and informed him of the visit. The Facility Designee, Arshalouis Manoukian arrived at approximately 10:27 a.m. Entrance Interview.

During today’s visit, the LPAs conducted a tour of the facility inside and outside to ensure there were no immediate health or safety hazards. The LPAs observed two residents sitting on the dining table, who reported they were doing well and were waiting for breakfast to be served. Residents did not report any concerns during today’s visit. All utilities were observed to be on and functioning properly. The LPAs observed the kitchen and food supply and there is a sufficient amount of both perishable and non-perishable foods.

At approximately 10:45 a.m., the LPAs observed an unlocked cabinet with resident’s medication accessible to residents in care. The Facility Designee placed the medication in a locked cabinet during the inspection.

The following deficiencies were cited from the Title 22 California Code of Regulations. (See LIC 809-D). The Facility Designee was informed that failure to correct the deficiencies may result in additional civil penalties. A civil penalty in the amount of $250 will be assessed today due to this being a repeat violation within 12 months.

Exit interview conducted with Administrator, appeal rights discussed and copy of report provided.