Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Yee conducted an announced Prelicensing and Component III visit to inspect the facility and to ensure that the facility is in compliance with Title 22 requirements. LPA Yee met with Karpis Arakelyan, Applicant and Elianora Yebeyan, Designated Administrator.

The facility is a single storey family home consisting of a living room, dining room, kitchen, 4 bedrooms and 2 full bathrooms. Attached to the home is an accessory dwelling unit that is not part of the facility operations. It has a separate address of 7446 Mammoth Avenue. The facility is fire cleared for 5 NON-AMBULATORY and 1 BEDRIDDEN residents. Bedroom #1 is designated for bedridden use.

The CARE Inspection tool was used on today's visit.

The following was observed on today's visit:

the living room was observed with a sofa, love seat, 2 end tables and a coffee table. The fire place was observed covered with a fire place screen. A large screen television is mounted over the fireplace.

the dining room was observed with a table and 6 chairs

the kitchen is equipped with a stove, a microwave, toaster, a large refrigerator and a small refrigerator for storage of medications, a small table with 4 chairs and a water filtration system. Sufficient plates, cups and bowls were observed for 6 residents. Pots and pans for preparation of meals were observed.

Dish soap and cleaning solutions are stored in a locked cupboard under the kitchen sink.

Sharp knives are stored in a locked drawer to the right side of the stove.

Insufficient non-perishable foods for minimum of 7 days were observed. Perishable foods for a minimum