Routine inspection·April 7, 2026

Licensing Program Analyst (LPA) N. Galarza arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation. LPA was greeted and granted entry by caregiver staff. Administrator Anna Khachatryan arrived later on to assist with inspection. Administrator has a valid administrator's certificate expiring on 3/ 8/2027. The following was observed during the inspection: Infection Control: The Infection Control Plan includes Environmental cleaning and disinfection activities. Operational Requirements: A Dementia and hospice waiver for 6 residents has been approved. A fire clearance for 6 non-ambulatory adults 60 and over; of which one (1) may be bedridden in room 4. Facility does not handle resident P & I monies. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 5/30/2026. Physical Plant/Environment Safety: The interior and exterior physical plant was inspected. The facility is a single-story home located in a residential area consisting of six (6) bedrooms, two (2) full bathrooms, kitchen, dining room, living room, laundry room, attached garage, and backyard has a patio area with 2 small water fountains and is landscaped with gravel. Rooms are equipped with required furniture and bedding. Cleaning supplies and toxic substances are inaccessible to residents. The facility has two fire extinguishers. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Electrical smoke and carbon monoxide detectors were tested and are operational. The facility maintains emergency food supply and water. Emergency Phone numbers, exit plan and programming schedules were posted. The building contains central air conditioning and heating. First aid kits/Manuals are kept in activity rooms; consisting of thermometer, tweezers, scissors, antiseptic, bandages, gauze. Exit doors are free of any obstruction. The last Emergency Disaster drill was conducted on 2/23/2026. *Four surveillance cameras were observed in the indoor common areas and two outdoor cameras. Staffing: A total 9 staff members provide care and supervision to the residents. Personnel Records/Staff Training: Staff have criminal background clearance and training. Five (5) staff files were reviewed. Proof of staff training, health clearance, and 1st Aid/CPR training is current in files. Resident Records/Incident Reports: A total of six (6) resident files were reviewed. They contained admission agreements, Physician's Reports, Appraisals, TB clearance, Physician's Orders, medical consent. RCFE complaint poster and Personal rights were observed posted. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. The facility does not have a Resident Council. Food Service: Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies. No resident have modified diets. Incident Medical and Dental: Centrally stored / 30-Day supply of medications were reviewed. Medical and dental transportation is provided by family. Disaster Preparedness: Emergency and Disaster Plan LIC 610E was reviewed. Facility has a First Aid Kit and Manual. Residents with Special Health Needs: One (1) resident receives hospice services and three (3) residents receive home health services. One resident is bedridden. No deficiencies were cited. An exit interview was conducted with Administrator Ani Karapetyan. A copy of the report was provided.