Facility Evaluation Report

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility to conduct a required annual inspection. Upon arrival LPA was greeted by staff and entrance interview and introductions conducted. Assistant Administrator Laila Kulungu was contacted and arrived to the facility.

At approximately 110:15a.m., LPA and staff 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. The following was observed: Fire extinguisher located in the kitchen was observed fully charge with receipt dated 10/2025. There is a functioning telephone on the premises. Emergency exiting plans/sketch are posted. Emergency telephone numbers are posted in the main hallway area wall. Other required postings are also posted on the main hallway area wall. KITCHEN: Kitchen knives are stored in a locked kitchen drawer. The supply of dishes, utensils, pots, pans, and drink ware is adequate. The supply of nonperishable food is adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen, and house cleaning supplies are stored and locked under the sink cabinet area. BEDROOMS: The facility has six (6) private residents’ bedrooms, and one (1) staff’ bedroom. All bedrooms observed with required furniture and clean linen. Lighting in the rooms appeared sufficient. BATHROOMS: There are three (3) bathrooms. Hot water temperature was tested in all restrooms and recorded between 109-118 degrees Fahrenheit. COMMON AREAS: The common areas were appropriately furnished, and the lighting was adequate. Entertainment equipment, books and/or activity supplies observed for residents use. There was sufficient space to accommodate both indoor and outdoor activities. Alarms on all exterior doors were engaged at the time of visit and functional. Garage was observed locked and contained extra food, PPE supplies, cleaning supplies, and water supply. Laundry room observed with supplies and chemicals locked in the cabinets. LPA reviewed the facility emergency disaster and infection control plan with Ms. Kulungu. (Continue to LIC809c)