Routine inspection·January 30, 2024

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection and was let into the home by Seda Hovhannisyan, Staff. Mary Petikyan, Administrator was contacted by staff and she arrived at 10:01am to conduct the visit. The reason for today's visit was explained. The facility is a single storey family home consisting of a living room, dining room, kitchen, 4 bedrooms, 2 common bathrooms, 1 private bathroom and a detached garage located in the back of the property. The facility is fire cleared for 5 NON-AMBULATORY and 1 BEDRIDDEN residents. Bedroom #4 is approved for bedridden use The following domains were reviewed on today's visit: Infection Control, Operational Requirements, Staffing, Personnel Records/Staffing Training, Resident Rights/Information, Planned Activities, Food Services and Incidental Medical and Dental. All 4 resident files and 6 staff files were reviewed. The following were observed: resident and staff all have health screens with the results of a TB test Admission Agreements were observed Resident and Employee Rights were observed. staff all have current first aid and CPR training. Administrator certificate expires on 8/26/24 Liability Insurance expires on 3/29/24 and meets the minimum Title 22 requirements of $1 million per occurrence and a total of $3 million per annual aggregate. Per review of Resident #3's health screen, the physician has determined that the resident is bedridden. However, Resident #3 is able to sit up, turn from side to side without assistance and transfer to wheelchair with staff assistance. The Administrator will contact the Resident #3's doctor and obtain clarification as to whether resident is considered to be non-ambulatory or bedridden. The Administrator will provide LPA Yee with an updated written status or a corrected LIC602 from the resident's physician by no later than 2/5/24. The need for citation and civil penalties will be determined once clarification has been obtained. Due to time constraints the following domains will be reviewed on a return visit: Physical Plant/Environmental Safety, Resident Records/Incident Reports, Disaster Preparedness and Residents with Special Health Needs. No deficiencies were issued on today's visit. Exit interview was conducted.