Facility Evaluation Report

On 12/11/24 Licensing Program Analyst (LPA) Daiquiri Boyd visited the facility to complete the Annual Inspection and was greeted by Administrator (AD) Chao Vang.

LPA reviewed three staff files and three resident files. All required postings were observed. Smoke alarms and carbon monoxide detectors were observed to be operating. The fire and disaster drill was last performed in July of 2024.

LPAs requested Licensee to submit the following documents: LIC308, LIC309, LIC500, Proof of Liability Insurance by 12/20/2024.

Administrators signature on this document confirms it's receipt.