Facility Evaluation Report

Licensing Program Analysts (LPAs) Emily Peraldi and Quoc Huynh arrived at the facility unannounced to conduct a required annual visit. At 10:05 a.m., the LPAs met with staff and explained the reason for visit. At 10:15 a.m., the Administrator, Mariam Kevliyan arrived at the facility.

At 10:20 a.m., the LPAs along with Administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards.

KITCHEN: The LPAs observed the kitchen/dining area. Knives are stored in a locked kitchen drawer. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 10:35 a.m., hot water measured at 106.0-degree Fahrenheit. Medications are located in a locked filing cabinet near the kitchen.

BEDROOMS: The facility is a single-story residential home with four (4) bedrooms and two (2) bathrooms. The LPAs observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level.

RESTROOMS: Restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid mats. At 10:21 a.m., hot water measured at 106.9-degree Fahrenheit. The sinks had sufficient liquid soap, and paper towels.

OUTDOOR SPACE: The LPAs observed the back patio which has a covered outdoor area for resident use. There is a gate on the side of the house designated for an emergency exit. Passageways were free and clear from obstruction. There are no bodies of water on the premises.