Routine inspection·March 18, 2025

At 12:30 PM, Licensing Program Analysts (LPAs), Huma Rahimi, and Angela Panushkina, conducted an unannounced annual inspection at the facility mentioned above. LPAs were greeted by the staff, Mari Akmakchyan, who granted access to the facility. LPAs explained the reason for the visit. This facility is licensed for the capacity of six (6) Ambulatory residents. Upon arrival, Mrs. Akmakchyan informed LPAs that the facility currently has five (5) residents, of which two (2) are bedridden and three (3) are ambulatory. LPAs were also informed that none of the residents are on Hospice. At approximately, 12:35 PM, LPAs conducted a tour of the facility, and the following was observed: Common Areas : The facility maintains a comfortable temperature at 73°F. The living room and dining area appeared clean and were properly furnished. No obstructions observed throughout the facility. The facility license was not posted and or available for review. Kitchen: LPAs observed sufficient supplies of staple non-perishable for 1 week and perishable for 2 days. At 10:15am, LPAs observed resident medications/injectable in the refrigerator unlocked. All knives and other sharps were observed locked in the kitchen drawer. LPAs observed all other medication locked in the kitchen cabinet. There is a fire extinguisher by the kitchen that was last purchased on 10/1/2024. Bedrooms: There are three (3) bedrooms designated for residents use and have sufficient lighting. All bedrooms have appropriate bedding and linens. LPAs observed two (2) half rail beds in room #1 and room #2, without Physician order. Physician's order for half bed rails were not available upon request. Moreover, LPAs observed a television stand that was blocking the emergency exit door. Continue on LIC 809C Bathrooms: LPAs observed two (2) bathrooms for resident use and both appeared to be clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPAs observed appropriate grab bar and resident's bathroom had non-skid mat. LPAs observed appropriate hand washing signs posted in each bathroom. Outside areas: At approximately, 12:50 PM, LPAs toured the outside area of the facility. LPAs observed a clean covered patio and backyard furniture to accommodate the six (6) residents. Laundry: Laundry room is located outside and during the walk though, LPAs observed the room locked and inaccessible to residents in care. Resident Files: At 11:00am LPAs conducted resident and staff records review. The following was observed. two (2) out of five (5) resident files were incomplete. Files were missing Admission Agreement, Resident Preplacement, Appraisals/Reappraisal, List of personal property, ID Emergency Sheets, and Personal Rights. Please see LIC858 included with this report. Staff Files: The following was observed. The Administrator has not renewed her Administrators Certificate since 08-26-2020, and the facility is currently have no active Administrator on file. LPAs conducted review of Licensing Information System and did not observe Staff #1(S1) being associated with the facility. S1's fingerprints determination on a guardian was: " Not Eligible. Determination Closed." Medications review: At approximately, 3:00pm LPAs conducted a review of medication for residents in care. All records were observed to be complete and updated. Administrative: . LPAs collected a copy of Liability Insurance and LIC500. Deficiencies and civil penalty issued, see LIC809Ds. Exit interview conducted, appeal rights explained and copy of report signed and delivered.