Facility Evaluation Report

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met Caregiver Issac Kung and explained reason for visit. Administrator David Kim arrived shortly.

The facility is licensed to serve 1 Ambulatory Resident and 12 Non-Ambulatory Residents ages 60 and over (of which 6 may be bedridden). Facility has a hospice waiver for 6, there are currently 3 residents using hospice services.

The Facility is a single story building located in Downey, CA. A tour of the facility included: 11 resident bedrooms, 7 bathrooms, living room, dining room, tv room, kitchen, laundry room, two (2) shaded patio areas, detached garage and tool sheds used for storage and emergency food supply.

LPA toured the facility and observed the following: Each resident bedroom has the required furniture and bedding. Extra linen was observed in laundry room. The Smoke detectors and carbon monoxide detectors were observed throughout the facility and are properly operating. The facility several fully charged fire extinguishers located throughout the facility. Cleaning supplies and toxic substances were observed to be accessible in two bathrooms. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. Facility was observed to have sufficient supply of 7 days non-perishable foods and 2-day perishable foods. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were not measured between the required range of 105-120 degrees F. The resident bathrooms have the required grabs bars and non-skid mats. There is a shaded seating area for the residents in backyard. Passageways and exits were not free of obstruction.