Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted an annual required visit. LPA met with administrator Bruce Chow and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. LPA observed the facility plant and COVID-19 procedures. Due to facility currently has no resident live here and staff work here and unable to review staff and residents files and resident's medication.

The facility is a single story house and located in a residential neighborhood area. The facility includes kitchen, laundry room, dining area, family room, staff bathroom, three residents' rooms, living room, resident bathroom and a attached garage. All 3 resident bedrooms were toured. Each resident room has two bed, two night stand, dressers, required linen and furniture, sufficient lighting and closet space. Resident's bathroom was toured and its clean, sanitary and in a good working condition. Bathrooms have the required grabs bars and non-skid mats. The hot water temperature was tested in resident bathroom was 120 degrees F which is within the required 105-120 degrees F. The refrigerator and kitchen pantry have sufficient two days perishable and seven days non perishable food supply. All the appliances are clean and working properly. The common areas such as living room and dining area are clean and have the required furniture. The smoke detectors and carbon monoxide detectors are interconnected and they are working probably. Auditory alarm devices to monitor exits were operable. Interior and exterior space available to permit residents to wander freely and safely.

Facility is currently following COVID 19 recommendations regarding COVID 19 signs throughout the facility, disinfecting products are available in each room and facility is disinfected every day, Bathroom have sufficient soap, paper towels, and signs, PPE supplies are stored for 30 days.

An exit interview was conducted. A copy of the report was provided to administrator Bruce Chow.