Routine inspection·November 27, 2023

On 11/27/2023 at 09:00 AM, Licensing Program Analyst (LPA) Christopher Alemoh conducted an unannounced Required – Annual Continuation Inspection and met with Staff Gayane Grigoryanya and Administrator Azniv Ter-Arsenyan. Six (6) residents and Two (2) staff were present during this inspection. Facility has been approved for a capacity for six (6) residents of the age of 60 age Facility has been approved for a capacity for six (6) residents in which five (5) may be non-ambulatory and one (1) bedridden. Hospice waiver has been approved for six (6) residents. The Annual Licensing Fees are current. The home consists of 1 floor level with: six (6) bedrooms and two (2) bathrooms kitchen, dining room, and laundry room and staff room. At 09:15AM the administrator accompanied LPA inside and outside the facility. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. The facility has six (6) bedrooms in which all will be single use. Bedroom number one (1) will be designated for bedridden residents. All the other rooms have been approved for non-ambulatory residents. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, hot water temperature properly measured between 110.9-111F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. Facility Temp observed at 69 degrees Fahrenheit. LPA toured the kitchen area and observed a two day supply of perishable and a seven day supply of non-perishable food. Knives and toxins were kept in locked storage cabinet next to the stove. First Aid kit/manual near the oven. One fire extinguisher, last serviced June 6 th , 2023, was observed on a wall next to the front entrance. LPA tested all carbon monoxide detectors and smoke detectors located in the kitchen area. Both devices were functional. LPA observed that all bedrooms and hallways are equipped with a carbon monoxide and smoke detector. Kitchen Temp measured at 112 degrees Fahrenheit. LPA reviewed Medication and Medication Records for Six (6) residents all medication files had the proper documentation. At 09:55AM Six (6) staff records were reviewed, 6 out of 6 staff records had current first aid certificates and had required criminal record clearances or criminal record exemptions. At 11:10AM Six (6) resident records were reviewed and, 6 out of 6 client records had Admission Agreements, Medical Assessments, Pre-appraisals (or Reappraisals) and/or Needs & Services Plans. Exit Interview Conducted / Appeal Rights Discussed / A Copy of the Report Issued.