Follow-up·October 17, 2025

Licensing Program Analyst (LPA) Michael Cava conducted a Case Management (CM) visit to the facility to follow up on Resident 1 (R1). LPA met with the assistant administrator, Grigor Petrosyan, and advised him of the visit. On 10/16/25, the Department received information that the facility admitted Resident 1 (R1), who is temporary bedridden. The facility has a fire clearance for six (6) non-ambulatory only. Today's CM visit consisted of a physical plant inspection and an assessment of R1. The facility is a one story building with six (6) bedrooms. All bedrooms are for private use. Each bedroom has it's own exit, with doorways that measure at approximately 48 inches. Hallways leading to the resident rooms measure between 48-54 inches. There are sprinklers installed all throughout the inside of the physical plant. During an assessment of R1, LPA observed R1 to be able to reposition in bed with some assistance. R1 does require assistance to get out of bed. According to the administrator, R1's status at the facility is temporary only. LPA requested for the licensee to submit the following in order to comply LIC 200 and facility sketch to request for a bedridden fire-clearance. (This is obtained during today's visit) An exception request to retain R1, which will include the following information Exception request letter from facility to Department 2. LIC 602 – Physicians Certification 3. LIC 625 - Appraisal Needs and Services Plan 4. Physician Orders 5. Medical Records (Orders from the Hospital, Discharge Summary, Home Health orders) 6. Facility plan of care for the health condition exception is being requested for…. 7. Staff training component to include topics and materials Exception request due to the Licensing Agency by Monday, October 20, 2025. Assistant Administrator advised and a copy of this report issued.