Facility Evaluation Report

LPA Sabrina Calzada arrived unannounced to conduct a Post- Licensing inspection and met with staff, Svitlana Petryk, who contacted Administrator, Christina Andreasyan. The Administrator and Hasmik Khachatryan, Administrator Designee arrived around 3:15 pm. LPA observed (2) residents in the common area and (4) residents resting in their rooms. The facility is licensed for (6) residents and has an approved hospice waiver for (2) residents. Currently, there are (2) residents under hospice care.

LPA and the care staff toured the interior/exterior of the facility including the common areas, (2) private resident bedrooms, (2) shared resident bedroom, (2.5) resident bathrooms, staff room, kitchen, laundry and garage. LPA observed the facility to be clean, in good repair and odor free. The bathrooms have the necessary grab bars, non-skid flooring, soap, paper towels. There is 2+ day perishable and 7+ day non-perishable food. Fire extinguishers were last serviced on 11/22/24. Sharps are locked in the kitchen and toxins are secured in the laundry room.

All required posting are visible in the common area. There is one exit gate in the backyard. There is patio seating and a covered table with chairs.

LPA observed both staff and resident files to be organized and contain required paperwork. Administrator to provide a current copy of liability insurance. Discussed process to increase the hospice waiver. LPA to provide information on the Department's Guardian.

There were no deficiencies observed. Exit interview. Copy of report provided.