Facility Evaluation Report

Licensing Program Analyst(LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool. LPA Yee was let into the home by Charity Chisale, Staff. Armenuhi Avetisyan, Administrator was contacted by telephone and she arrived at 10:41am to conduct the visit.

The facility is a single storey home consisting of a living room, dining room, kitchen, 3 resident bedrooms, 2 common bathrooms of which one is designated for staff use, a staff room and a attached garage. The home is fire cleared for 5 non-ambulatory and 1 bedridden. Bedroom #3 is approved for bedridden use.

On today's visit, LPA Yee reviewed all 12 domains of the CARE Inspection Tool, 3 residents and 6 staff files and toured the physical plant, inside and outside and the following was observed:

the living room, dining room and kitchen were furnished and equipped with the appropriate furniture for its designated use. The fireplace was observed with a fire screen.

Bedroom #1, located in the front of the home is currently used as a private room and was observed with a hospital bed equipped with half bed rails and no written physician's order was observed to indicate the need for the bed rails, 2 night stands, 2 lamps, a chair and a built in closet. No dresser was provided at the request of the resident. The bed linens were provided as per the resident's personal request.

Bedroom #2 located adjacent to the attached garage was observed with 2 hospital beds, The left bed was observed with a full bed rail and the empty bed was equipped with a half bed rail. No written