Facility Evaluation Report

Licensing Program Analyst (LPA) Perchui Milena Khurshudyan conducted an unannounced Case Management-Legal/Non-compliance visit. LPA met with Rima Agaronyan - Administrator Designee, who granted access to the facility and informed that due to health condition facility Administrator won't be able to join the visit. LPA explained the reason for the visit, and conducted entrance interview.

On 7/30/2024, a Non-Compliance Conference (NCC) was held at the Regional Office (RO) to discuss complaint # 31-AS-20211116143735 and other facility deficiencies. As a result of that NCC, the facility was placed on a two-year compliance plan.

At that time, the Regional Manager (RM) and Licensing Program Manager (LPM) advised the Administrator should strive to remain in full compliance Relevant Title 22 Regulations.

The purpose of today’s visit is to conduct thorough inspection to ensure compliance. LPA conducted a physical plant tour to ensure the health and safety of the clients and that the physical plant was in compliance with CA Title 22 Regulations.

Today’s focus was staff and resident records for accuracy, required documentation for Exception Requests, Residents health condition.

LPA was informed that the facility currently has five (5) residents. The facility also has three (3) staff members and LPA checked the Licensing Information System (LIS) and observed that all staff members are associated with this facility and the fingerprints are cleared.

No deficiency cited during todays Case Management visit.

Exit interview conducted and copy of this report signed and delivered.