Facility Evaluation Report

On 11/27/2024 around 04:00 PM, Licensing Program Analyst (LPA) L. Holmes conducted an unannounced Annual Inspection. LPA explained the purpose for the visit to Aiyan Li, Administrator (ADM).

The facility does not have any residents at his time. There is a COVID-19 mitigation plan and Emergency Disaster Plan on file; hand sanitizer, COVID-19 signage, and a surplus of PPE is stored in the facility that is accessible to all care staff. LPA and ADM toured the facility to include but not limited to the common areas, bathrooms, bedrooms, kitchen, and backyard. LPA advised ADM to add covered garbage cans to all shared bathrooms, remove debris from the backyard and ensure all passageways are clear. There was a sufficient supply of 2-day perishables and 7-day supply of non-perishable foods. All hand washing stations were equipped with soap, paper towels and garbage cans. Hot water temperature in the shared residents' bathroom was measured at 112.6 degree Fahrenheit (F) and the facility's temperature was at a comfortable degrees. Fire extinguisher were observed full and Smoke/Carbon Monoxide detectors were observed operational; first aid kits complete.

The following forms are to be updated and submitted to CCLD:12/04/2024

-LIC308 Designation of Administrative Responsibility

-LIC610E Emergency Disaster Plan (Reviewed)

-An updated copy of Administrator Certificate(s)

Exit interview conducted and a copy of this report provided to the ADM.