Routine inspection·May 20, 2021

Licensing program Analyst (LPA) Naira Margaryan conducted unannounced Required 1-year visit to the facility. LPA met the Administrator Anna Vardanyan, explained the purpose of this visit and was greeted by the administrator herself. LPA observed one (01) residents was in the living room watching TV. Three (03) residents were comfortably resting in their respective bedrooms. . A tour of the physical plant was conducted with Ms. Vardanyan. The facility has three (3) bedrooms and two (2) bathrooms currently occupying four (4) residents. The facility is licensed to care for five (5) non-ambulatory residents and has hospice waiver for two (2). Physical environment was checked for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings, and doors were checked and meets requirements. Living and dining room furniture were also checked. The living room is neat and clean along with the dining room. The facility maintains a comfortable temperature. The smoke/carbon monoxide detectors are hardwired and interconnected and observed to be operational. The backyard of the facility has outdoor furniture, with a covered shaded area for clients. There is no body of water at the facility. The Administrator's office is located in the backyard and was observed to be locked and inaccessible to residents. There is also a separate storage which was also observed to be locked. The laundry area is located in the backyard locked and inaccessible to residents. The garage is detached to the home and inaccessible to residents. The garage is currently being used as an emergency food and supplies storage, Laundry detergent and other toxins are also kept in there. Food Service/Kitchen area was sufficiently stocked with two (2) days perishable food and seven (7) days of non-perishable food. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean. Fire extinguisher is located in the kitchen and observed to be fully charged but not inspected since May 2019. The Administrator contacted her spouse, who went to buy a new fire extinguisher. Knives and sharps were observed to be locked in a kitchen cabinet. The Clients' rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are clear from obstruction. Clients have sufficient amounts of personal hygiene product which is provided by the licensee. The bathroom was checked for cleanliness and proper operation. LPA observed the appropriate grab bars in the toilet and shower. The hot water temperature was measured at 119.6°F. Towels and washcloths are not shared. There was enough clean linen available in stock at the cabinet. Medications : LPA observed that the medication was kept in the kitchen cabinet locked and inaccessible to residents. Medications are listed on the centrally stored medication and destruction record. There was a complete first aid kit located in the medication cabinet. Required posting including Covid 19 emergency postings as well as other documents are observed to be complete and displayed properly at the facility. The copies of facility mitigation and emergency disaster plan was requested and reviewed with the Administrator. No health and safety hazard is noted during this visit. Exit interview conducted. Copy of this report issued.