Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted an unannounced annual inspection. LPA met with administrator, Jungea Chun and explained the reason for the visit. The facility is licensed for 4 adults, ages 18 through 59, of which 2 may be non-ambulatory. Rooms #2 and #3 are approved for non-ambulatory. There is currently no client residing at the home.

The facility is a one story house consisting of 4 client bedrooms, 2 bathrooms, living room, dining area, kitchen, office area, and detached garage. The laundry area is located outside in the backyard. The spacious back yard is well maintained and has a shaded area and sitting area for client to use. There are no pool or bodies of water on the premises. Each clients bedroom has the required furniture, lighting, and closet space. Knives and cleaning products are locked in the kitchen cabinets. Smoke and carbon monoxide combo detectors are located in each room. The hot water temperature was measured between the required range of 105-120 degrees F. The food supply is adequate. There is a centrally stored medication cabinet located in the kitchen area. However, no medications were reviewed since there are no clients. Staff and Client files will be stored at the facility. LPA requested to email the updated Emergency Disaster Plan LIC610D for review.

No deficiencies were issued. However, LPA provided technical advisories.

An exit interview was conducted and a copy of the report was given to the administrator.