Facility Evaluation Report

On 1/27/2025 at 1:10PM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Shengxi Liu, and explained the purpose of the visit. The Co-Administrator certificate expires on 4/27/2025. The facility’s fire clearance was approved for five (5) non-ambulatory and three (3) bedridden residents.

LPA toured the facility with Co-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. The hot water temperature in the residents’ shared bathroom was measured at 114.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher is not tagged. Emergency Disaster Plan was last posted on 8/29/2019. First aid kit was observed to be complete.

Facility did not have both Co-Administrator and one (1) staff files complete including CPR/First Aid Certificates available. Three (3) residents files were reviewed were complete.