Facility Evaluation Report

On 1/17/2024 at 9:30AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Administrator, Ada Osuka and explained the purpose of the visit. The facility’s fire clearance was approved for 5 clients of which 1 maybe non-ambulatory.

LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, and outdoor area. Smoke and carbon monoxide combination detectors were observed in operating condition. Fire extinguisher was observed to be full. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 115.4 degrees F in the hallway bathroom. There were adequate lighting in each room. First Aid kit is complete. Last fire drill was conducted on 1/1/2024.

LPA reviewed 3 clients and 3 staff files starting at 10:15AM. LPA interviewed 2 clients and 2 staff at 10:55AM. LPA reviewed a sample of client's medications starting at 12:15PM.

No deficiencies are being cited on this date.

Exit interview conducted. A copy of this report provided.