Facility Evaluation Report

An unannounced Required One (1) year visit was conducted on this day by Licensing Program Analyst (LPA) Gary Tan. LPA met with Sara Lewis, friend of the administrator Dyntaie Lee. Ms. Lewis called the administrator, purpose of the visit is stated. Administrator designated Ms. Lewis to sign the report. This will be a North Los Angeles Regional Center (NLARC) vendored facility Level IV-A., per the administrator.

LPA conducted physical plant tour inside and out at 9:38 AM. During the tour, LPA observed that the facility has four (4) bedrooms and two (2) bathrooms. There is no body of water in the facility.

The front main door is the only entrance being utilized at the facility. The facility had submitted and approved Mitigation and Infection Plan.

The facility has a designated visitors' area at the backyard.

Bedrooms : Two (2) of the bedrooms are unfurnished during this visit and the other two (2) have bed and being used by family members.

Bathrooms were observed to be relatively clean and with necessary supplies. Hot water temperature measured at a range of 111. 2°F to 115. 7°F .

Living and dining room furniture were also checked for functionality (wear and tear). Living area has sofa but there is no dining table and chairs.

Kitchen area is under construction and per the administrator, due to a leak, they have removed all the furniture at the facility.