Facility Evaluation Report

Licensing Program Analysts (LPAs) Joseph Alejandre and Sean Haddad made an unannounced visit to conduct a health and safety check. LPAs were greeted and granted entry by staff. LPAs met with Administrator (AD) Marjan Arastoo and staff Abdol Arastoo and explained the reason for the visit. AD stated there were 8 staff total present at the facility. LPA Haddad toured the facility with Abdol, including first floor, second floor, kitchen, laundry room, resident rooms, common areas, and bathrooms and observed no health and safety issues. LPA Haddad observed the facility has their State License posted. LPA Haddad observed the fireplace in the dining room has a metal screen. The dining room has 9 tables and numerous chairs and can accommodate all of the clients. The dining room is well lit and no obstacles or hazards were observed. The exit door leading outside from the dining room is operational. LPA Haddad and Abdol toured the kitchen. LPA Haddad observed a 2 day perishable and 7 day non-perishable food supply on hand. LPA Alejandre observed the utility sink in the kitchen was no longer leaking from the drain pipe. The kitchen was clean and the stove is operational. LPA Haddad observed a staff member preparing for the lunch service. LPA Haddad observed the fire extinguisher is fully charged. LPAs observed the activity schedule posted and there was a current monthly menu posted next to the dining room entrance. Administrator reported there are daily activities and a dedicated staff member for activities.

LPA Haddad and Abdol tested the water temperature in 6 rooms on the first and second floor and the water temperature tested between 108.3 and 117 degrees F. LPA Haddad observed all the light fixtures are working and all of the fire extinguishers are fully charged. LPA Haddad observed furniture and mattresses on the end of the hallway on the second floor have been removed.

LPA Haddad reviewed 5 resident files and observed all have current needs and service plans but 1 of which was missing a physician's report. LPA Haddad inspected the medication room, noted medication was secured, and that facility is documenting the medications. LPA Alejandre verified all staff were associated to the facility. LPA Alejandre reviewed 11 staff files and observed the records to be complete.