Facility Evaluation Report

On 1/04/2024 at 9:30AM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Chunjie Hu, and explained the purpose of the visit. Shengxi Liu, Co-Administrator arrived at 10:20pm. The Administrator certificate has expired as of 5/4/2023 and is working on renewal process. The Co-Administrator currently holds a certificate (#6043972740) that expires on 04/27/2025. The facility’s fire clearance was approved for five (5) non-ambulatory and three (3) bedridden residents.

LPA toured the facility with Administrators including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of six (6) total bedrooms, and two (2) bathrooms. No bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. However the light bulbs in both bathrooms need to be replaced. The hot water temperature in the residents’ shared bathroom was measured at 114.7 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 02/2/2022. Emergency Disaster Plan was last posted on 11/20/2023. First aid kit was observed to be complete.

Facility did not have both Administrator and two (2) staff files including CPR/First Aid Certificates available. Four (4) residents files were reviewed were incomplete.