Routine inspection·March 9, 2022

Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced Required- 1-year visit focusing on COVID-19 Infection Control Practices. LPA was greeted by Geghettsik Ishagharyan, Caregiver and House Manager Harut Sargian, and Assistant Administrator Michael Petrosian arrived a short time later and LPA explained the purpose of the visit. Administrator certificate expires 09/10/2022 Last fire drill was on 03/01/2022 Structure: The Facility is a single storey building in a residential area with 3 shared resident bedrooms and there’s 1 dining room, 2 full bathrooms, a kitchen. A laundry room, and a family room. There is a large garden area on the back premises with tables and chairs and shade. All the resident’s bedrooms are spacious and will easily accommodate the resident's furnishings. The passageway and walkways are free of hazard and free from obstruction. The following were observed/inspected: · COVID-19 signs are posted at the entrance. Visitors are screened in the main entrance and a log is kept. · Water temperature measured between 105 – 120 degrees F which is within regulation range. · Infection control signs and other COVID-19 signs are posted throughout the facility in the bathrooms, kitchen, and hallway to promote handwashing, cough/sneeze etiquette, and physical distancing. · Facility does not has one designated isolation room. Facility Assistant Administrator will put them up in hotel room or send them to alternate home. · Three client rooms, common areas, bathrooms, and outdoor physical plant was inspected. · Three client rooms were equipped with alcohol-based hand sanitizer. · Five (5) centrally stored client medication records were reviewed. . · Staff responsible for direct care and supervision were observed wearing masks. · Clients were not observed wearing masks but adhering to public health social distance guidelines. · Sufficient supply of perishable food for 2 days & non-perishable foods for 7 days were observed. · A posted Emergency Disaster Plan was observed posted at facility. · PPE's were observed. · Staff and resident files were not reviewed during today's visit. · Deficiencies were observed during today’s visit. (please see 809D) · Exit interview was conducted with Assistant Administrator Michael Petrosian. A copy of the report was provided.