Facility Evaluation Report

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 09:56AM. Upon arrival, LPA met with staff and House Manager Farnaz Servati who arrived at 10:02AM and Administrator Vishtasb Kykhosrowpour who arrived at 10:17AM. Entrance interview conducted.

At 10:03AM, the LPA along with the House Manager, 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: The LPA inspected the kitchen/food service area at 10:03AM. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and nonperishable food. Food labels were inspected and checked for expiration dates and food labels had expiration date clearly marked. Knives and chemicals were locked inaccessible in kitchen drawer and under-the-sink cabinet.

BEDROOMS: There are six (6) private resident bedrooms. Bedroom #1 has a direct exit to the exterior. LPA observed resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting.

RESTROOMS: There are four (4) restrooms designated for resident-use of which two (2) restrooms are attached to resident bedrooms and two (2) are located in the hallway . Restrooms were clean and sanitary and in operating condition with grab bars and slip-resistant surfaces. The restrooms were sufficiently stocked with supplies and paper towels; towels and washcloths are not shared. Hot water temperature was measured in three (3) bathrooms and measured between 115.4-119.2 degrees Fahrenheit, which is within the required range. Report Continued on LIC 809-C