Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool and was let into the home by Anush Nersesyan Staff. Staff contacted Siranush Bagdasarian, Administrator via telephone and she arrived at 11:01am to conduct the visit. Also present at the facility on today's visit were Kevin Poghosyan and Karine Abrahamyan, Staff. The reason for today's visit was provided.

The home is a single storey family home consisting of a living room, dining room, kitchen, four resident bedrooms, 2 full bathrooms, a staff lounge and a attached garage that was recently converted to an ADU. The facility is fire cleared for 5 non-ambulatory residents and 1 bedridden resident. Bedroom #3 is approved for bedridden use.

On today's visit all 12 domains of the CARE Inspection Tool was reviewed. 6 Resident files and 5 Staff files were reviewed. A tour of the facility inside and outside was conducted.

the living room was appropriately furnished. The fireplace was covered with a fire screen. Located in the living room was a fire extinguisher that was last tested on 8/9/25 and due for an inspection. The second fire extinguisher is located by bedroom #2

the dining room was furnished with a dining room and 4 chairs and a bench. Located in the dining room is the only carbon monoxide detector. It was tested and was operational