Facility Evaluation Report

LPA K. Nguyen arrived at the facility rang the doorbell three times no one answer. LPA waited outside the stairway. LPA tried to contact the facility administrator, and licensee no response. LPA left a VM waiting for a call back from Administrator/ Licensee. While waiting LPA observed a car in the driveway, all blinds are down, and none are at the facility. LPA will attempt another visit at a later time.

On 06/13/2024 at 11:45 AM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Licensee/Administrator (AD), Ricky Ng and explained the purpose of the visit. The facility’s fire clearance was approved for capacity for four (4). In which two (2) can be Non-Ambulatory and the other two (2) can be Ambulatory. Administrator Certificate #6054877735 expired 12/16/2023. AD is waiting for new administration certificate to arrive.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 4 total bedrooms which 3 bedrooms are occupied by the clients and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature for clients is maintained at 69 degree Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 111.3-degree Fahrenheit. All toilets, hand washing and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for clients.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last purchased 11/08/2023. Emergency Disaster Drill was last posted on 02/01/2024. First aid kit was observed to be complete. Fire drill was last conducted on 05/3/2024. Centrally stored medication and sharps were locked and inaccessible to residents. There is a minimum of one week supply of nonperishable and 2-day of perishable foods.

At 12:00pm, LPA reviewed 3 residents records. At 12:30 pm, LPA reviewed 2 staff records and 2 of 2 have current first aid training and associated to the facility.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided via email.