Facility Evaluation Report

On 12/16/2025 at 10:00AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Administrator, Alexandria Liu and explained the purpose of the visit.

LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full and last serviced on 8/14/2025. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 112.4 degrees F in the hallway bathroom. LPA observed grab bars and non-skid mats in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. First Aid kit is complete.

LPA reviewed 3 residents and 4 staff files starting at 10:25AM. LPA reviewed a sample of resident's medications during inspection.

At 11:30AM, LPA observed S4 has a positive TB skin test, but does not have a copy of the chest x-ray on file.

At 11:45AM, LPA observed S4 does not have current First Aid training certificate on file.

At 1:00PM, LPA was informed that facility does not have documentation for fire drills conducted.