Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted an annual inspection on 5/14/26. LPA met with Staff and explained the purpose of the visit. Administrator, Anthony Ngo, arrived shortly after. The fire clearance is approved for 6 residents, ages 60 and over, of which 2 may be non-ambulatory. There are 6 individuals residing at the facility and is vendorized by the San Gabriel/Pomona Regional Center.

LPA inspected the facility using the Compliance and Regulatory Enforcement (CARE) tools.

The facility consists of 3 resident bedrooms, 1 staff room, 2 bathrooms, living room, dining area, family room, and kitchen. The fireplace is secured with a cover. No swimming pool on the premises. Bathrooms have non-skid mats and grab bars. Knives, cleaning solutions, and disinfectants are locked. The hot water temperature was measured between the required range of 105-120 degrees F. Sufficient food supplies of 2 day perishable and at least a week of non-perishable are observed. There is sufficient space to accommodate indoor and outdoor activities. There is a carbon monoxide detector in the hallway and smoke detectors around the home.

LPA reviewed 3 staff files. Administrator's certificate expires on 12/25/26. Staff have current CPR & First Aid certificates and are receiving annual training. LPA reviewed 6 resident files and they have the required documents. Medications are centrally stored and locked. All the residents are given their medications as prescribed and accurately marked on the Medication Administration Record. The Complaint poster, Local Ombudsman, and Residents personal rights are posted. The Emergency Disaster Plan is posted and reviewed annually by the administrator. Disaster drills are conducted at least quarterly.

No deficiency was issued today. An exit interview was held and a copy of this report was given to Staff Langa.