Alleviate Care

Type of visit: Required - 1 Year

At 12:30pm, Licensing Program Analyst (LPA), Angela Panushkina conducted an unannounced annual inspection at the facility mentioned above. LPA met with the Designee, Victorya Hayrapetyan, and explained the reason for the visit. Facility is licensed for capacity of five (5) Non-Ambulatory residents in rooms #3, #4 and #6 only. Hospice waiver is granted for five (5) residents. At approximately 12:45pm, LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. There is a fire extinguisher in the kitchen, and it was last serviced on 08/28/2025. LPA observed five (5) bedrooms designated for residents’ use. All bedrooms have sufficient lighting, properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational. Facility also has awake staff at night. There are three (3) full bathrooms. All bathrooms were observed to be clean and in good repair. Properly supplied with toilet paper, soap and paper towels. The hot water temperature measured at 120.00°F. LPA observed appropriate grab bar and non-skid mat. All trash cans in bathrooms had fitted lids to protect them from cross contamination. The facility maintains a comfortable temperature at 73°F. The Common areas are furnished with adequate furniture to accommodate a maximum capacity of six (6) residents. Continue on LIC809-C At approximately 12:50am, LPA observed medications are centrally stored and locked in the cabinet, located at the office, and inaccessible to residents in care. The first-aid kit has been inspected which has at least the following: tweezers, scissors, antiseptic, bandages, gauze, thermometer; including a current First Aid manual. At 12:50pm, smoke and carbon monoxide detectors were tested and observed to be operable. At 1:00pm, LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. The outdoor area was free of visible immediate hazards. LPA discussed the importance of maintaining care and supervision to meet the needs of residents. Between 1:20pm to 2:20pm, LPA reviewed records of six (6) residents and two (2) staff. Client and staff records appeared to be complete and updated. LPA observed Administrator certificated renewed on 10/07/2024 with an expiration date of 10/06/2026. LPA collected Certificate of Liability Insurance and LIC500. No citations were issued during this visit. Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Apr 1, 2026

Type of visit: Required - 1 Year

At 11:40 AM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced annual visit. LPA met with staff and later Administrator and disclosed the reason for the visit. LPA and Administrator toured the facility inside and out. The facility is a single story building with 5 bedrooms, 3 bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for 6 residents, of which 5 may be non-ambulatory. The facility serves residents with dementia. Approved hospice waivers for 5. Kitchen: At approximately, 11:50 AM LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. Kitchen surfaces were sanitary, and all appliances were functional. Sharps were locked below the counter, and cleaning solutions were locked in separate cabinet in the kitchen. LPA observed a fully charged fire extinguisher in the kitchen. It was last inspected on 10/02/2024. Medications: At approximately, 11:55 AM LPA observed medications are centrally stored and locked in the front entrance/office of the facility in a cabinet. LPA also observed an additional locked cabinet where resident and staff files are kept. Bedrooms: LPA observed total of five (5) bedrooms designated for resident use. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Facility has awake staff. Bathrooms: LPA observed three (3) bathrooms and all bathrooms appeared to be clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed appropriate grab bar and resident's bathroom had non-skid mat. LPA observed appropriate hand washing signs posted in each bathroom. At 12:13 PM, hot water temperature measured at 116.2°F. Continue on LIC809-C Common Areas: The facility maintains a comfortable temperature at 73°F. The living room and dining area appeared clean and were properly furnished. The living room has a television, comfortable furniture. No obstructions and or tripping hazards throughout the facility. LPA observed an operable washer and dryer in locked room next to the garage. All detergents were stored and locked. The garage was also observed locked, which had extra emergency food and cleaning supplies stored inside. Smoke detectors/carbon monoxide. At 12:20 PM, LPA tested the dual-function smoke and carbon monoxide detector to be operational. When tested, 3 out of 3 detectors functioned simultaneously, and the fire door closed. 2 out of 2 auditory alarms were on and functioning. Outside areas: At approximately, 12:25 PM LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. There is no bodies of water or swimming pool at the facility. All emergency exit paths were free from obstructions. Exit gates were unlocked. Between 12:30 PM to 1:30 PM, LPA reviewed records of five (5) residents and two (2) staff. Resident 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.the state’s words, verbatim · CDSS document, Dec 9, 2024

Allegation investigated: Staff does not maintain accurate records for resident.

At 10:00am, Licensing Program Analysts (LPAs) Angela Panushkina and Perchui Milena Khurshudyan conducted an unannounced initial complaint visit at this facility to investigate the above allegation. LPAs met with the Administrator and explained the reason for the visit. During course of the investigation, interviews and record review were made. At 10:05am, LPAs requested resident and staff roster. At 10:10am, LPAs requested copies of pertinent information which include, but not limited to Admission Agreement, Physician’s Report, Appraisal Needs and Services Plan, Power of Attorney, etc., relevant to the investigation. At approximately 10:15am, LPA conducted a physical plant tour, to ensure health and safety of the residents are protected and physical plant is in compliance with Title 22 Regulations. Between 10:20am – 12:30pm, LPAs interviewed the Administrator, one (1) staff and four (4) out of six (6) residents. Continue on LIC9099-C Unsubstantiated Allegation: Staff does not maintain accurate records for resident. It was alleged that the suspected abuser (SA) presents himself/herself as R1's Power Of Attorney (POA) and has been signing consents on R1's behalf. To investigate this allegation, LPAs conducted an interview with the Administrator and were informed that R1 has a POA and all required documentation on file. Review of R1's file revealed that SA was assigned to be POA for R1 as of 11/15/2018. Based on interview and record review this allegation is deemed Unsubstantiated at this time. No deficiency cited during today's visit. Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Apr 24, 2024 · control 31-AS-20240416162206