Facility Evaluation Report

This report supersedes previous report, It is being changed to correct type of visit and nothing else has changed.

Licensing Program Analyst (LPA) Alberto Lopez conducted an announced annual inspection visit and met with Ilki Baek, Caregiver, and discussed the purpose of the visit. . The facility has an approved fire clearance for 11 non-ambulatory residents, and three (3) bedridden residents. The facility is a single-story home: 9 bedrooms, and 7 bathrooms, dining/ living room, backyard with detached garage used for laundry and storage, located in Alhambra, CA

The facility staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has sufficient PPE supplies, an Infection Control Plan. Bathrooms have hand washing signs, soap and paper towels. Facility Administrator is adhering to infection control requirements.

Operational Requirements: Facility has proper fire clearance and shaded area for activities.

Staffing : There is sufficient staffing at the facility. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.

Personnel Records-Training : Staff files are maintained at the facility. LPA reviewed staff files for Facility Administrator, and S1-S3. Staff have current CPR/first aid training and sufficient on-going training that meets the annual requirement. Staff have their Health Screening and Tuberculosis Screening on file. Staff are also trained in Abuse Reporting. Administrator Certificate expires on 09/08/2026. (Continued on 809C)