Facility Evaluation Report

Licensing Program Analyst (LPA) Sandra Urena arrived at the facility unannounced to conduct a required annual inspection. The LPA was greeted by staff and informed them of the reason for the visit. Licensee Kristina Adamyan arrived shortly thereafter.

The LPA and the licensee 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.

Kitchen: Knives are stored in a locked drawer in the kitchen. The facility has a sufficient supply of perishable and nonperishable food. Additional food is located in the garage. There is an adequate supply of emergency food and water. Appliances were clean and all appeared functional. Kitchen, laundry and house cleaning supplies are stored in a locked cabinet in the kitchen and in the garage. At 1:27 p.m. the LPA and the licensee observed five cockroaches in a cupboard under the oven.

Bedrooms: The facility has six bedrooms. Five rooms are designated for resident use. There are four private resident bedrooms (Rooms #1, 2, 4, 5) and one shared room (Room #3). Room #3, Room #4, and Room #5 have direct exits to the outside. Rooms are set up with beds, nightstands, lamps, chests of drawers, chairs and closet space. Lighting in the rooms appeared adequate. Room #6 is a designated staff room. At 12:30 p.m. the LPA and the licensee observed the staff's bedroom to be unlocked. Over the counter medication (Nexium) with one pill on top of the lid, was observed within reach of the residents. The Licensee promptly removed the medication and locked the room.

Bathrooms : There are four bathrooms, and out of the four bathrooms, one is designated as a staff bathroom. Restrooms are clean and sanitary with grab bars and non-skid surfaces. Rooms #3 and #5 have an attached bathroom. Restrooms were fully stocked. Hand-washing signs were observed in all restrooms. At 12:40 p.m. the LPA and the licensee observed shaving razors on top of the sink and under the sink, to be within reach of residents. The non-skid mat in the bathroom #1 was found to have mold.