Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an announced visit for pre-licensing follow up inspection. The applicant notified the department for visit since corrections were made. The initial pre-licensing visit was conducted on 09/08/2022. LPA met with Phuoc Truong (Henry), applicant/administrator, to discuss the purpose of today's visit and the inspection.

During this visit, LPA observed the following corrections were made:

1) Water Temperature: Tested at 114.0 degrees Fahrenheit

2) Resident records: Stored in a cabinet with a lock and inaccessible to residents

3) Alarm auditory devices at exits: all exits are installed with alarm auditory devices.

4) Resident bedrooms: Mattress pads are in place in all residents' beds

5) Resident bedrooms: A chair is available in each residents' room

6) Side gate exits: Side gate exits are self-closing and not locked.

7) Laundry room with cleaning compounds: Laundry room's door is installed a lock and inaccessible to residents.

8) Backyard: Water host is rolled and mounted on the wall.

Component III was conducted with applicant during the initial visit on 09/08/22. No further corrections are needed.

An Exit interview was completed with Administrator. A copy of this licensing report LIC 809, dated 09/15/2020, has been furnished to applicant. Applicant is advised to contact Centralized Application Bureau regarding the status of the application.