Facility Evaluation Report

Licensing Program Analyst (LPA)) Alberto Lopez conducted an announced subsequent pre-licensed visit to verify corrections and met with Hyo Sook Kim, Licensee and Okkyung (Julie) Coreas, Administrator for the purpose of inspecting corrections.

The following were inspected and corrected

· Side of garage and back of the home needs to be cleared of debris - corrected.

· Documents for personnel records need to be available (LIC500) -corrected.

- Mattress pads for all beds.- corrected.

- Sample Menus for one calendar month. - corrected.

- Facility needs new shower chair - corrected.

- All trash bins must have lids - corrected.

- Room #4 needs a lock on the bathroom door and hot water in the faucets. - corrected.

- Room 9 needs tub clutter removed. - corrected.

- Food for 2-day perishable and 7 days non-perishable and perishable - corrected.

- Facility needs to fix fence or replace fence - corrected.

- Bedroom 8 needs new dresser. - corrected.

- Disaster and Mass casualty plan - corrected

· Blinds in the front room need repair or replacement. - Front room has broken blind on window and

· Blinds or blackout curtains in rooms and in the living room. - 2 living room windows need black out curtains or blind

- All faucets must have cold and hot water within department regulations. - needs corrections.

Facility Administrator will advise LPA of corrections to schedule subsequent visit if required. Exit interview and copy of report provided.