Facility Evaluation Report

On this day 03/27/2023 at around 12:15PM, Licensing Program Analyst (LPA) L. Ibo arrived at the facility to conduct annual required inspection. LPA was met by caregiver S3. Administrator Renee Tang was called to inform her the purpose of the visit, according to Administrator she is not available to meet with LPA since she is at her other facility. At around 1:05PM, staff Joy Bisaha arrived at the facility.

LPA inspected the facility inside and out including but not limited to bedrooms, bathrooms, kitchen, garage dining and living areas. The facility has 4 bedrooms and 2 bathrooms. One bedroom is designated as staff room/office room and 1 bathroom is dedicated for staff room. There are 2 clients observed. Facility has an approved fire clearance for 6 ambulatory clients. One fire extinguisher was observed by the dining room adjacent to kitchen, date of service was April 2022.

Facility has sufficient supply of perishable and non-perishable foods. There are 1 staff working during the visit and both are fingerprint cleared. Bathroom were observed with grab bars and nonskid mats.

LPA reviewed 2 clients and 2 staff files and interviewed 2 clients and 2 staff. Facility has wired carbon monoxide and smoke detector that were observed functional.