Pre-licensing visit·November 3, 2025

Licensing Program Analyst (LPA) Trevor Byrne conducted a pre-licensing visit to the above noted facility. The LPA met with Administrator Erna Gevorgyan and Applicant Representative Kazar Mkrtchian. This is a new facility. A dementia program was included in the plan of operation. A Hospice Waiver has been requested. The facility is a one story home. At 10:01 AM, a physical plant tour was conducted inside and out. An approved fire clearance was received, clearing them for five (5) non-ambulatory residents and, one (1) bedridden resident. The facility has three (3) shared rooms, Rooms # 1, 2, and 3. Rooms two (2) and three (3) have direct exits to the outside and are the bedridden approved rooms. All resident rooms are set up with beds, nightstands, lamps, chests of drawers, chairs and closet space. The beds are furnished with box springs, comfortable mattress and clean linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket if needed and a bedspread. Lighting in the rooms appeared adequate. Bedrooms # one (1) and three (3) were large enough to allow for easy passage between the beds and furniture with a wheelchair or walker. Bedroom #2 was observed to contain two (2) resident beds which did not allow for easy passage between the beds and furniture with a wheelchair or walker. During the visit one (1) bed was removed from the room to allow for enough space for easy passage. LPA informed the Administrator and Applicant Representative that alternate furniture arrangements must be made if a second bed is added to bedroom #2 to ensure exits and passageways remain clear from obstruction. The Applicant Representative and Administrator expressed understanding. In addition, no bedroom was used as a passageway to another room, bath or toilet. There are no staff rooms awake night staff are required. All rooms were free of odors. All window screens were clean and maintained in good repair. Continued on LIC 809C. There are two (2) bathrooms in the hallway. The resident bathrooms have a shower with non-skid materials. The toilet and shower have grab bars. The hot water temperature was tested in the bathrooms and the kitchen and was found to be within the range of 105*F and 120*F. Resident and staff records are stored in a locked cabinet which is currently located in the hallway. Medications are centrally stored in a locked cabinet in the kitchen. The first aid supplies were complete, including a thermometer. A current version of a first aid manual was ordered and was expected to be delivered 11/04/2025. They were stored on the counter in the kitchen. Kitchen knives are stored in a locked drawer in the kitchen. Stove burners are rendered inaccessible to the residents by removing them when not in use. The supply of dishes, utensils, pots, pans and drinkware is adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of nonperishable food is adequate. There are no pesticides, poisons, or toxins stored in any food storage area or preparation area with utensils. Appliances in the kitchen were clean and all appeared functional. Kitchen, laundry and house cleaning supplies are stored in locked cabinets located in the laundry room and facility hallway. No flies or other vermin were observed. The common areas were appropriately furnished, and the lighting was adequate. There was a television and other entertainment equipment, games and/or activity supplies in the living room and entryway. There was sufficient space to accommodate both indoor and outdoor activities. Night lights were maintained in hallways and passageways to nonprivate bathrooms. Stairways, inclines, ramps and open porches and areas of potential hazard to residents with poor balance or eyesight were made inaccessible to residents unless equipped with sturdy hand railings and unless well-lighted. All ramps were secure and non-slippery and were positioned at the level where wheelchairs and walkers may enter and exit the facility safely. There is an electric fireplace in the living room. It is screened and there are no tools. Alarms on all exterior doors were engaged at the time of visit and functional. In addition, the physical plant is consistent with the submitted facility sketch/floor plan. The facility had emergency lighting, which included flashlights and batteries. The facility has a furnace, which is able to heat rooms that residents occupy to a minimum of 68 degrees Fahrenheit; and, they have air conditioning and are able to cool rooms to a comfortable range, not to exceed 85 degrees Fahrenheit. Continued on LIC 809C. The facility smoke alarm system is hard wired. The smoke detector and carbon monoxide detectors were tested and functioned properly during the time of visit. There were two (2) fire extinguishers throughout the house. They were fully charged and did not exceed the expiration date. LPA observed a fire door of the facility to not be equipped with a magnetic catch. LPA informed the Administrator and Applicant representative that the fire door must remain closed when not in use and not propped open during operations. The Applicant representative and Administrator expressed understanding and agreed to comply. Hot water was tested in each bathroom, which included the resident bathrooms and the kitchen; and, the hot water ranged from 109.8 to 116.6 degrees Fahrenheit. The laundry area is located adjacent to the kitchen. The supply of extra bed and bath linens is adequate. Personal hygiene items, shampoos, and soaps were adequate and are stored in a locked cabinet in a shared resident bathroom. There is a functioning telephone on the premises. The emergency exiting plans/sketch are posted in each resident room and throughout the facility. The emergency telephone numbers are posted in the dining area. Other required postings are posted near the entryway of the facility. The exterior passageways were clean and clear of any obstructions. There is a shaded patio area at the front of the house with tables and chairs where residents can sit. The entire property is fenced. The back and garage of the house are separated from the front yard by a fence and gate. The gate to the driveway is moved automatically. There is a door w/gate with a self-latching mechanism for persons to enter the front yard. There are not any bodies of water on the premises at the present time. The garage is not accessible from the house. LPA had a conversation with the applicant representative and Administrator that the garage is to be used as a garage only. Both the applicant representative and Administrator expressed understanding. COMP III orientation was completed with the applicant during this pre-licensing inspection. The following item must be corrected prior to licensure. Submit proof of corrections, along with a copy of this report, to LPA Byrne so that your application may be completed. Continued on LIC 809C. This report will be sent to the Centralized Application Bureau (CAB) once all corrections are received. You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. 87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (8) If a facility has no medical unit on the grounds, a complete first aid kit shall be maintained and be readily available in a specific location in the facility. The kit shall be a general type approved by the American Red Cross, or shall contain at least the following: (A) A current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency.