Routine inspection·October 11, 2025

On 10/11/2025 at approximately 09:20 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by the caregiver and stated the reason for their visit. The Administrator, Armen Markosian arrived shortly after to assist with today’s visit. LPA asked for the census, Staff/Resident Roster, and Liability Insurance. LPA conducted a physical plant tour at approximately 12:30 PM and the following was noted: The facility is a single-story building with four (4) bedrooms and two (2) bathrooms. The facility is currently occupying six (6) residents. There is no designated staff room. The facility has an approved fire clearance for six (6) non-ambulatory residents of which one (1) may be bedridden. Hospice waiver approved for four (4). Common areas: The living room and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 74°F. LPA observed a fire extinguisher to be located near the kitchen and dated 06/03/2025. LPA observed required postings such as Long-Term Care Ombudsman, Emergency Disaster Plan, and Personal Rights to be located alongside the entrance. A working telephone was observed. Kitchen: The kitchen was observed to be clean and free from pests. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. Knives/sharps were observed to be kept in a locked kitchen drawer. The cleaning solutions/toxins were observed to be kept locked underneath the kitchen sink. Kitchen appliances were observed to be working and in proper condition. (continued on LIC 809-C) Bedrooms: The residents’ rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are lighted appropriately. Extra linens/covers were observed to be stored in cabinets located within the hallway’s passageway. Bathrooms: The bathrooms were checked for cleanliness and proper operation. The hot water temperature was measured within regulations. LPA observed appropriate grab rails and slip-resistant mats to be in proper condition. Front/Backyard: The front yard of the facility is equipped with a designated shaded area with outdoor furniture for residents. The backyard of the facility was observed to be clean. There is no body of water located at the facility. Laundry Room: The laundry room was observed to be located outside of the facility. LPA observed the laundry room to be kept locked. LPA observed cleaning solutions and toxins stored appropriately within the laundry room and inaccessible to residents. The laundry appliances were observed to be working and in proper condition. Garage: LPA observed there to be no garage. Medications: The medications along with staff and residents’ files were observed to be kept in a locked cabinets located near the kitchen. First-aid kit observed to be equipped with but not limited to bandages, scissors, digital thermometer, tweezer and First-Aid Manuel. Smoke detectors and carbon monoxide observed to be working properly and were tested. Residents/Staff Records: LPA conducted a complete file review of resident records. Resident records were not complete and/or updated. Staff records: LPA conducted a complete file review of staff records. Staff records were not complete and/or updated. (Continue to LIC 809-c) The following deficiencies were observed during the day of inspection: -LPA observed R2 to have a postural support (Belt) attached to them and their wheelchair without a physician’s order. -4 out of 6 residents were missing their updated re-appraisals. -4 out of 6 residents were missing their annual medical/ Physician's report. Citations issued, please refer to 809-D. There were no other immediate health and safety hazards observed during the day of inspection. Exit interview conducted, appeal rights given and a copy of this report was provided to the Administrator.