Routine inspection·April 28, 2025

On 4/28/2025 @ 10:30am, Licensing Program Analyst (LPA) Leizl de la Cerra conducted the required 1 year annual inspection with staff/caregiver, Siranush Mkhitaryan. Administrator, G ayane Agazaryan was contacted but was unavailable. LPA was informed by the administrator that Siranush Mkhitaryan was given consent to sign the report. This is a single story residence consists of four (4) bedrooms and two (2) bathrooms. Fire Clearance was approved on 01/17/2019 for five (5) non-ambulatory residents and one (1) bedridden in bedroom #2. All four (4) bedrooms are designated for resident use A tour of the physical plant was initiated at approximately 11:55pm and the following was observed: The smoke alarms and carbon monoxide detector are hard wired and inter-connected. Staff tested the dual smoke/carbon monoxide detector @12:30pm and was observed to be operational. The facility has two fully charged fire extinguishers inspected on 4/18/2025. One fire extinguisher is located in common room area, and the other in the kitchen. KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, microwave oven and sink. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). Knives are kept in a locked box. There is a staff workstation located at the corner of the kitchen. BEDROOMS: There are four (4) bedrooms designated for resident use. Bedroom #1 and #2 are private rooms, with bedroom #2 having a bedridden fire clearance (per STD 850). Bedrooms #3 and #4 are shared rooms. The resident's bedrooms are furnished with beds, night stand, chairs, dresser, bedding and linen. The bedrooms have sufficient lighting and closet space. BATHROOMS: The facility has two (2) bathrooms for the resident's use. Both bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water temperature measured between 106°- 110°F. COMMON AREAS: These included the living room and dining room. The living room was equipped with furniture, a television, tables and sofas. There is a fireplace with a screen. No fireplace tools or fixtures present. The dining area has a large dining room table to accommodate six (6). There were no visible immediate hazards. GARAGE/LAUNDRY ROOM: The washer and dryer is located in the garage, which is kept locked. The garage is also used as extra storage for non-perishable and emergency food supplies and water. MEDICATIONS: The medications are kept locked in a kitchen cabinet. Resident Files : LPA conducted reviews of all six (6) resident's files from 10:45am to 11:45am to insure compliance of licensing forms. Resident files are kept locked in cabinet, located the kitchen. Staff Files : LPA conducted reviews of three (3) staff member's files from 12:45pm to 1:30pm. Staff files are also kept in a locked cabinet located in the kitchen. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The backyard of the facility has a patio and backyard furniture with umbrella to accommodate the six (6) residents. The facility backyard has sufficient yard space. LPA did not observe any body of water at this facility. During the visit today, LPA observed no deficiencies. Technical advisories provided. An exit interview was held. A copy of this report, technical advisory note was provided