Routine inspection·April 1, 2026

At 12:30pm, Licensing Program Analyst (LPA), Angela Panushkina conducted an unannounced annual inspection at the facility mentioned above. LPA met with the Designee, Victorya Hayrapetyan, and explained the reason for the visit. Facility is licensed for capacity of five (5) Non-Ambulatory residents in rooms #3, #4 and #6 only. Hospice waiver is granted for five (5) residents. At approximately 12:45pm, LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. There is a fire extinguisher in the kitchen, and it was last serviced on 08/28/2025. LPA observed five (5) bedrooms designated for residents’ use. All bedrooms have sufficient lighting, properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational. Facility also has awake staff at night. There are three (3) full bathrooms. All bathrooms were observed to be clean and in good repair. Properly supplied with toilet paper, soap and paper towels. The hot water temperature measured at 120.00°F. LPA observed appropriate grab bar and non-skid mat. All trash cans in bathrooms had fitted lids to protect them from cross contamination. The facility maintains a comfortable temperature at 73°F. The Common areas are furnished with adequate furniture to accommodate a maximum capacity of six (6) residents. Continue on LIC809-C At approximately 12:50am, LPA observed medications are centrally stored and locked in the cabinet, located at the office, and inaccessible to residents in care. The first-aid kit has been inspected which has at least the following: tweezers, scissors, antiseptic, bandages, gauze, thermometer; including a current First Aid manual. At 12:50pm, smoke and carbon monoxide detectors were tested and observed to be operable. At 1:00pm, LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. The outdoor area was free of visible immediate hazards. LPA discussed the importance of maintaining care and supervision to meet the needs of residents. Between 1:20pm to 2:20pm, LPA reviewed records of six (6) residents and two (2) staff. Client and staff records appeared to be complete and updated. LPA observed Administrator certificated renewed on 10/07/2024 with an expiration date of 10/06/2026. LPA collected Certificate of Liability Insurance and LIC500. No citations were issued during this visit. Exit interview conducted and copy of this report signed and delivered.