Routine inspection·August 27, 2025

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 10:00 a.m., the LPA met with staff and explained the reason for it visit. At 10:20 a.m., Administrator Arpine Mkrtchyan arrived at the facility. RECORD REVIEW: Between 10:15 a.m. and 11:26 a.m., the LPA conducted a file review for all four (4) residents and staff regularly scheduled and observed the following: Staff have current first aid and training documentation. Resident records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All files were in order. The Administrator’s Certificate is valid until 10/13/2025. The last fire drill took place on 07/01/2025. The LPA observed documentation of the Infection Control Plan and Emergency and Disaster Plan. At 10:54 a.m., the LPA conducted a review of medication and medication documentation with the Administrator for two (2) out of four (4) residents and observed that medications were properly documented and assisted as prescribed. Medications are locked and centrally stored in a filing cabinet inside the kitchen. At 12:40 p.m., the LPA, along with the Administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards. KITCHEN: The LPA observed the kitchen and dining area. Knives are stored in a locked drawer. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 12:49 p.m., hot water measured at 115.5-degree Fahrenheit. Continued on LIC-809-C. BEDROOMS: The facility is a single-story residential home with three (3) bedrooms and three (3) bathrooms. The LPA observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. RESTROOMS: Restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid mats. Starting at 12:52 p.m., hot water temperature measured between 106.5 and 111.6-degree Fahrenheit. The sinks had sufficient liquid soap, and paper towels. Signs are posted throughout the facility restrooms to promote handwashing. OUTDOOR SPACE: At 1:00 p.m., the LPA observed the back patio which has a covered outdoor area for resident use. There is a gate on the side of the house designated for an emergency exit. There are no bodies of water on the premises. Additional food supplies and water are stored in the garage. Laundry units are located inside the locked laundry room. Cleaning solutions are located inside the laundry room. COMMON AREAS: The LPA observed common area to be relatively clean and properly furnished. The LPA observed the fire extinguisher to be fully charged and purchased on 11/12/2024. At 1:04 p.m., fire alarms/carbon monoxide detectors were tested and functioned properly. All exits have functioning auditory devices and were operational at the time of the visit. There is a working telephone on premises. The LPA observed additional clean linens and towels in the hallway closet. No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.