Facility Evaluation Report

Licensing Program Analyst (LPA) Teresa Camara conducted a pre-licensing visit to the above noted facility. The LPA met with applicant Ani Ghazaryan. This is a new facility. A dementia program was included in the plan of operation. A Hospice Waiver for six (6) has been requested.

The facility is one-story. At 2:20 p.m., a physical plant tour was conducted inside and out. An approved fire clearance was received, clearing them for five (5) non-ambulatory residents and one bedridden resident in room number three (3). The facility has three (3) double-occupancy resident bedrooms. Bedrooms number one (1) and two (2) do not have direct exits to the outside; bedroom number three (3) has an exit with a ramp. There is a fire door to the hallway. All resident rooms are set up with beds, night stands, lamps, closet organizers for folded clothes, chairs and closet space. The applicant must still purchase chest of drawers for each resident. The beds are furnished with spring bed bases, comfortable mattresses and clean linen; which includes, a mattress cover, top and bottom linens, pillowcases, blanket (if needed) and a bedspread. Lighting in the rooms appeared adequate. The bedrooms were large enough to allow for easy passage between the beds and furniture with a wheelchair or walker. During the visit it was observed that in bedroom number three (3) the beds would need to be moved to allow easier access to the private bathroom. In addition, no bedroom was used as a passageway to another room, bath or toilet. There is no designated staff room, therefore awake night staff is required. All rooms were free of odors. All window screens were clean and maintained in good repair.

There is a half bathroom in the hallway and each bedroom has a full bathroom for a total of three and a half bathrooms in this house. The resident bathrooms each have a shower with non-skid mats. The toilets and showers have grab bars. The hot water temperature was tested in the bathrooms and the kitchen and was found to be within the range of 105*F and 120*F; with an average of 115.3*F.