Facility Evaluation Report

Licensing Program Analysts (LPA) Joseph Alejandre made an announced visit to conduct the required annual inspection. LPA was greeted and granted entry by Staff. LPA met with Assistant Administrator Julie Gorordo and explained the reason for the visit. Administrator Arda Kardjian's Administrator certificate expires on September 18, 2027. The facility is a Resident Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for six. The facility is a one story home with six residents bedrooms, one staff room, six bathrooms, a living room, a kitchen, a dining room, and an attached two car garage. LPA and Assistant Administrator Julie Gorordo conducted a tour of the physical plant. LPA observed four residents in care and three caregiving staff present. LPA observed the See Something Say Something poster (PUB 475) mounted on the wall by the entryway of the facility. LPA inspected all six residents bedrooms. All resident bedrooms has the required furnishings of, a bed, a chest of drawers, a chair, and a lamp. Resident bedrooms were clean and spacious. LPA inspected resident bathrooms. Resident bathrooms were equipped with grab bars and non-slip mats. Faucets and toilets were operational. Hot water temperature measured between 109.5 and 114.4 degrees Fahrenheit. LPA observed additional linens stored in a hallway closet. LPA observed the facility has a two day perishable and seven day non-perishable food supply on hand. LPA observed the five burner gas stove lights unassisted. LPA observed knives stored in a locked kitchen cabinet. LPA observed chemicals stored under the kitchen sink in a locked cabinet. LPA observed a fire extinguisher mounted on the wall in the kitchen. The fire extinguisher is charged and serviced as of November 4, 2025. LPA tested the smoke/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on December 2, 2025. The centrally stored medication is stored in a locked cabinet in the dining room. LPA observed the First Aid kit has all the required components. CONTINUED ON 809-C.