Routine inspection·September 16, 2025

At 1:45 PM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced annual visit. LPA met with the staff Knark Vardanyan and the Administrator was contacted via telephone. LPA disclosed the reason for the visit. The Administrator arrived shortly after. LPA and the Administrator toured the facility inside and out. It is a single story building with five (bedrooms, three (3) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for six (6) residents, of which six (6) may be bedridden. Approved hospice waivers for six (6). Kitchen: At approximately, 2:00 PM, 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 observed to be locked in a kitchen drawer. LPA observed a fully charged fire extinguisher hung in the kitchen purchased on 01/29/2025. A laundry area near the kitchen contained an operable washer and dryer. Cleaning solutions were locked near the appliances. LPA observed disinfecting wipes in one of the kitchen drawers unlocked and accessible to residents in care. Medications: At approximately, 2:05 PM, LPA observed medications are centrally stored and locked in a moveable cabinet located in an office area near the main entrance. Garage: LPA observed the garage locked and contained extra food, a second refrigerator, and PPE, incontinence supplies. Continue on LIC809-C Bedrooms: The facility had five (5) bedrooms. Three (3) bedrooms were private and two (2) were shared. All bedrooms contained a chair, nightstand, lamp, storage, and bed with adequate bedding. All furnishings were clean and in good condition. LPA observed over the counter medication unlocked and accessible in bedroom #5 with Resident #1. LPA also observed half bed rails for three (3) out of five (5) residents in bedroom #1 (shared room), and bedroom #5 without Physician order. Facility has awake staff. Bathrooms: LPA observed three (3) bathrooms and all bathrooms appeared to be clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed appropriate grab bar and client's bathroom had non-skid mat. LPA observed appropriate hand washing signs posted in each bathroom. LPA observed disinfecting wipes in one of the bathrooms attached with bedroom #5. At 2:15 PM, hot water temperature measured at 150.6°F. Common Areas : The facility maintains a comfortable temperature at 71°F. The living room and dining area appeared clean and were properly furnished. The living room has a television, comfortable furniture. No obstructions and or tripping hazards throughout the facility. Smoke detectors/carbon monoxide . At 2:20 PM, LPA tested the dual-purpose smoke and carbon monoxide detector to be operational. All detectors were hard-wired, and the facility uses fire sprinklers. All auditory alarms were on, functioning, and centrally wired. Outside areas: At approximately, 2:25 PM LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. The emergency exit path was unlocked and free from debris. Between 3:10 PM to 4:10 PM, LPA reviewed records of five (5) residents and two (2) staff. Residents and staff records appeared to be complete and updated. Administrative: LPA collected Certificate of Liability Insurance, and LIC500. Deficiencies issued during today’s visit. Appeal Rights explained. Exit interview conducted and copy of this report signed and delivered.