Pre-licensing visit·July 14, 2025

Licensing Program Analyst (LPA) Evelin Rios conducted a Pre-Licensing Inspection with the applicant representative, Romik Mkrtchyan and the administrator Kristine Manukyan. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 01/07/2025. A fire clearance was approved on 01/28/2025 for five (05) non-ambulatory residents and one (01) bedridden resident for a total capacity of six (06). At entry LPA observed appropriate postings and a sign in area for visitors with hand sanitizer available. A tour of the physical plant was initiated at approximately 9:45 a.m., and the following was observed: KITCHEN: The kitchen is equipped with a refrigerator, microwave, stove/oven and dishwasher. There is a sufficient supply of seven day non-perishable food items. Applicant has a sufficient amount of tableware, dishes and utensils to accommodate the capacity of six (6) residents. Knives and sharps were observed locked in lock box on the kitchen counter. COMMON AREAS: These included the living room and dining room. The living room is furnished with one couch, one recliner and one television. There is a fireplace that is properly screened. The dining room table is large enough to seat the capacity of the facility. Floors and furniture were observed to be in good repair. Entry and exits were clear of obstruction. The smoke alarms and carbon monoxide detector are dual and inter-connected. The facility is equipped with two (02) fire doors that closed automatically when the smoke detector was tested at 10:12 a.m. The fire extinguisher is located in the kitchen and was observed fully charged with purchase date 12/19/2024. BATHROOMS: The facility has three (3) bathrooms. Two (2) bathrooms are accessible to residents and visitors and the third bathrooms is located in the staff bedroom. Resident bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water temperature was measured in both resident bathrooms and they read between 113.5 and 120 degrees Fahrenheit, within regulation. BEDROOMS: There are five (5) bedrooms total. Four (04) are designated for residents. Per STD 850, Bedroom #5 has bedridden fire clearance. Bedrooms #1 and #2 are shared. The applicant furnished the resident bedrooms with beds, night stand, foldable chairs, dressers, and bedding. The bedrooms have sufficient lighting and closet space. Facility windows and screens were observed in good repair. LAUNDRY: The washer and dryer is located in a locked laundry room. In the laundry room the facility stores detergents and cleaning supplies. GARAGE: The garage is attached to the house. The door leading to the garage will be maintained locked. The garage stores facility's overflow of items and emergency food and water. OFFICE/STAFF WORKSTATION: Staff office is located by the kitchen, resident and staff records will be kept in a locked cabinet. Centrally stored medications, first aid kit and manual will be kept locked in cabinet. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alarms when the doors open. The backyard of the facility has a patio and appropriate backyard furniture to accommodate the six (6) residents. The facility's backyard has sufficient space for outdoor activities. There are no bodies of water. There is shed that will be locked for gardening tools. The applicant and administrator completed component III. Pre-Licensing is complete and this facility has no deficiencies. This report will be sent to Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when the license has been approved. Exit interview was conducted with administrator. A copy of this report was signed and delivered.