Facility Evaluation Report

Licensing Program Analyst(LPA) Christine Yee conducted an announced Prelicensing and Component III visit to inspect the physical plant to ensure that the home met Title 22 requirements. The complete CARE Inspection Tool was utilized. LPA Yee met with Marine Ghukasyan, Applicant. Also present during the inspection was Gevorg George Gevshenyan, family member.

The home is a single storey family home consisting of a living room, dining room, family room, kitchen, 4 bedrooms of which one will be used for live-in staff and as an office, 2 full bathrooms and a attached garage. The facility is fire cleared for 5 NON-AMBULATORY and 1 BEDRIDDEN residents. Bedroom #2 is the room designated for bedridden use.

The following was observed on today's visit:

The living room was observed with a piano, a bench and a coffee table. Fire place was capped off but does not have a fire screen.

The dining room was observed with a large table and 8 chairs.

The family room was furnished with a leather sofa, love seat, arm chair, foot stool, a little armchair, coffee table and television. The fireplace did not have a fire screen. The sliding glass door was equipped with an operable auditory device. The top of screen door was observed to be separated from the frame and needs to be fixed

The kitchen is equipped with a stove, dishwasher, coffee machine and microwave. There was sufficient non-perishable foods observed for a minimum of 7 days. No perishable foods were purchased on today's visit. The Applicant was advised that perishable foods for a minimum of 2 days must be purchased prior to the acceptance of the first resident. The following was observed: 20 dinner plates, 12 bowls, 8 cups, 6 tall glasses, 6 short glass, 7 salad plates, 8 saucers, 3 serving bowls, 12 forks,