Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Yee conducted a scheduled Pre-licensing and Component III visit to ensure that the home meets Title 22 requirements and met with Armenak Saakyan, Applicant. The complete CARE Inspection Tool was used on today's visit

The facility is a single storey family home consisting of a living room, dining room, kitchen, 4 resident bedrooms, an office/staff room, 3 full bathrooms, laundry room and a attached garage. The facility is fire cleared for 5 non-ambulatory residents and 1 bedridden resident. Bedroom #4 is approved for a bedridden resident. Garage is to be used as a garage only.

All domains of the CARE Inspection Tool was reviewed on today visit. The following were observed on today's visit:

The living room had the appropriate furnishing and seating for 6 residents. The front door is equipped with an auditory device

The dining room had a dining table and chairs for 6 residents and 2 chairs. The sliding glass door is equipped with an auditory device.

The kitchen is equipped with a refrigerator, stove, microwave and toaster. Sufficient cups, dinner plates, glasses, utensils were observed for 6 residents. Pots and pans for cooking were observed. Perishables foods for a minimum of 2 days and non-perishables foods for a minimum of 7 days were observed. Six, five gallon bottles of water were observed stored in the kitchen. Water temperature read 119.2 degrees Fahrenheit

The facility has 2 fire extinguishers - one located in the kitchen and one in the dining room. Both were purchased on 6/19/24.

The laundry room was observed with a washing machine and dryer. Detergents and cleaning solutions are also stored in the laundry room. Located in the room is also a full bathroom designated for staff use.