Facility Evaluation Report

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual. Upon arrival LPA met with Administrator Anna Hakobyan and explained the reason for the visit.

The facility is One story. At 10am LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The facility has (4) private bedrooms. Room #2 is a designated staff room and LPA observed it to be empty and inaccessible to residents at this time.

All resident rooms are set up with beds, nightstands, lamps, chests of drawers, chairs and closet space. The beds are furnished with box springs, comfortable mattress and clean linen; which includes, a mattress pad, 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. In addition, no bedroom was used as a passageway to another room, bath or toilet. All rooms were free of odors. All window screens were clean and maintained in good repair.

There is (1) bathroom in the common area designated for resident use. Bathroom nearest kitchen is designated as a staff restroom; The resident bathroom has a shower with non-skid materials and mat. The toilet and shower have grab bars. The hot water temperature was tested in the bathroom and the kitchen and was found to be within the range of 105*F and 120*F. Bathroom located in room # 5 is not in use and only accessible by Administrator at this time.

Resident and staff records are stored in the locked entry way closet. Medications are centrally stored in this area as well. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. They were located in the kitchen / office area. No sharp objects or other dangerous items were observed in first aid kit at this time.