Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 11:04 AM. LPA was greeted and asked to sign in by facility staff. LPA then met with Licensee/Administrator Gulira Atakeeva. Entrance interview conducted.

At 11:20AM, the LPA, along with the Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed:

BEDROOMS: The facility is a two-story residence, however the upstairs area is designated for staff use only and is made inaccessible using a gate. LPA observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The downstairs area of the facility consists of 5 (five) total bedrooms, 4 (four) are designated as private resident rooms and 1 (one) is designated as a shared resident room.

RESTROOMS : Downstairs area contains 4 (four) total restrooms, 2 (two) of which are private restrooms and 2 (two) are designated as shared restrooms. All restrooms observed were clean and sanitary and in operating condition with grab bars and non-skid surfaces. At 11:27AM, hot water measured at 124.7 degrees Fahrenheit in Room 1's private resident restroom and at 11:34AM, hot water measured at 125.2 degrees Fahrenheit in one of the shared resident restrooms.

COMMON AREAS : The LPA observed common area to be relatively clean and properly furnished at the time of the visit. The LPA observed the fire extinguishers to be fully charged and last serviced on 02/15/2023. A fireplace was observed to be adequately screened and inaccessible to residents in care. At 04:40PM, fire alarms and carbon monoxide detectors were tested and functioned properly. The temperature was maintained at a comfortable level. Report Continued on LIC 809-C