Senior Care Records.

Facility Evaluation Report

HMS Home, Van Nuys11/30/2023Licence 197609546

Capacity6
Census6
Date signed12/01/2023 07:58:24 AM
The inspector’s account

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool and met with Zhanna Davtian, Administrator. The reason for today's visit was explained.

The facility is a single storey family home consisting of a living room, a dining room, a kitchen, 4 resident bedrooms, 3 full bathrooms and a attached garage. Located along the left side of the home and directly behind the garage is a fenced in swimming pool. The home is fire cleared for 5 NON-AMBULATORY and 1 bedridden resident. Bedroom #3 is designated for bedridden use.

The following were observed on today's visit:

The living room has the appropriate sitting for 6 residents, a coffee table, a television and a side table. The fireplace has a wire screen. The sliding glass door is equipped with a auditory device (operational)

The dining room has a table with seating for 6 residents. The sliding glass door is equipped with a auditory device(operational)

The kitchen has a stove, 2 microwaves and a refrigerator. Sufficient perishable foods were observed in the refrigerator. Sharp knives are stored in a locked box and is kept in a kitchen drawer.

Adjacent to the kitchen is the laundry room with a washer and dryer. Detergents and cleaning supplies are stored in a locked cupboard.

The garage is accessed through the kitchen and is primarily used for storage of the 7 days of non-perishable foods, 24 gallons of water, facility files, centrally stored medications, and bathroom supplies.

Bedroom #2 and #4 both contain a twin bed, a chair, a night stand, a lamp and a closet. No dressers were observed.

Bedroom #1 and #3 both contain 2 twin bed, 2 chairs, 2 night stands, 2 lamps and 2 closets. No dressers were observed.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction