Routine inspection·June 2, 2025

At 12:30 PM, Licensing Program Analyst (LPA) Huma Rahimi, conducted an unannounced annual inspection at the facility mentioned above. LPA met with the Administrator Maryam Harutyunyan and explained the reason for the visit. Physical tour was conducted with the Administrator and LPA observed the following: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven, sink. Stove was observed in a good working condition. LPA 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 locked box in the kitchen. LPA observed all cleaning supplies to be locked under the kitchen sink. A fire extinguisher was hanging on the kitchen wall and last serviced on 01/13/2025. BEDROOMS: LPA observed that there are three (3) bedrooms for residents use only. Bedroom # one (1) and bedroom # two (2) are private, and bedroom # three (3) is shared. Bedroom # one (1) is cleard for a bedridden resident. LPA observed all bedrooms properly furnished with beds, dressers and required bedding, chest drawer, and linen. The bedrooms have sufficient closet space and have sufficient lighting. Facility will have a no live-in staff at the facility. LPA did not observe any obstruction or hazard. BATHROOMS: At 12:40 PM, LPA observed two (2) bathrooms of which one (1) is for staff use and one (1) for residents use. The bathroom for residents was observed to be clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed to have appropriate grab bar and a non-skid mat. At 12:42 PM, the water temperature was noted at 117.1°. Continue on LIC 809C COMMON AREAS: LPA observed all common areas to be clean in good repair. The facility maintains a comfortable temperature at 71°F. The living room and dinning rooms were properly furnished. No obstructions and or tripping hazards throughout the facility. MEDICATION: The medication and facility staff/resident files will be kept in a locked cabinet located in the living room by the entrance. During the medication review, LPA did not observe ay discrepancies. LAUNDRY ROOM: The laundry room is located outside with a secured and locked door. The washer/dryer appear to be in good condition. Laundry supplies are kept inaccessible all the times. SURROUNDING GROUNDS: The facility has a front yard and has sufficient space. LPA observe appropriate outdoor furniture, and a covered shaded area for residents . There is no swimming pool or any bodies of water at the facility. SMOKE DETECTORS/CARBON MONOXIDE. Smoke detectors and carbon monoxide were located throughout the facility. They were tested and observed to be operational. Between 1:30 PM to 2:30 PM, LPA reviewed records of four (4) residents and two (2) staff. Residents and staff records appeared to be complete and updated. Administrative: LPA collected Certificate of Liability Insurance, and LIC500. No deficiency cited during today’s visit. Exit interview conducted and copy of this report signed and delivered.