Facility Evaluation Report

On 12/11/2024 at 9:30am Licensing Program Analyst (LPA) Perchui Milena Khurshudyan arrived at this facility to conduct a Required Annual Inspection. LPA was greeted by the Administrator Rima Agaronyan who granted access to the facility. LPA Khurshudyan reviewed the required postings on a wall in the living room area. The inspection tool was used to complete the visit.

At 10:00am. LPA along with Rima Agaronyan – Administrator began a physical plant tour of the facility and the following was observed by the LPA: This is a single-story building with five (05) bedrooms, three (03) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for six (6) residents of which six (6) may be non-ambulatory, one (1) bedridden for Room #1. Facility has Hospice waiver for six (6) residents.

Kitchen: LPA observed a seven day supply of non-perishable food and a two day supply of perishable foods; properly stored and labeled. Facility stores knives, sharps, and chemicals in a separate locked cabinets in the kitchen. LPA observed one (1) fire extinguisher located by the kitchen fully charged with a serviced date of 9/7/2024. A weekly menu was also available posted in the kitchen.

Common Areas: These include the living areas and the dining areas . LPA observed dining, living areas clean and clear of clutter with furniture in good repair. Dining and living room furniture sits the capacity of the facility. Walls, floors, windows, screens, ceiling fans, and blinds were clean and in good repair. At 11:45pm. LPA measured the room temperature to be 74 degrees Fahrenheit. There is an adequate supply of fresh linens ready to use in each residents’ bedrooms.

LPA observed a gated fireplace in the living room and got informed that the fireplace is non operational. There was a television and various activities, games, board games stored inside the cabinet located in the living room.