Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Jen Tuto and explained the purpose for today’s visit, shortly after Administrators Mike and Hiransha Keerthisinghe arrived and assisted. The facility is licensed to serve 1 ambulatory and 5 non-ambulatory residents ages 60 and above, one of which may be bedridden (room #4 is approved for bedridden resident). Facility has a hospice waiver for 2 (currently there are 2 residents receiving Hospice services).

The facility is a single-story home located in Bellflower, Ca. A tour of the facility includes: living room, dining area, kitchen, 4 bedrooms, 3 bathrooms (2 of which are private baths), attached garage with laundry, and front/back yard.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit todays visit and the initial visit and observed the following:

Infection Control: The facility maintains the required Infection Control Plan.

Operational Requirements: The facility has an approved fire clearance, there is a plan of operation with required Infection Control Plan and facility maintains the required liability insurance.

Staffing : There appears to be sufficient staffing at all times in the facility.

Personnel Records-Training : Staff has criminal record clearance, current First-Aid/CPR/AED training along with training in postural supports, medication assistance, and other ongoing training are documented in personnel files and in-service training file. LPA reviewed 4 staff files with no issues observed. Administrator Dhammike Keerthisinghe ("Mike") certificate expires on 12/27/2026.