Facility Evaluation Report

Licensing Program Analyst's (LPA's) Glenn Trueman, Ashley Calderon, and Valeria Maldonado made an announced visit and was greeted by Administrator Jennifer Kim, Vice President Michael Kim and Assistant Administrator Mylene Bumanlag and explained the reason for the visit.

The purpose of the visit is to conduct the pre licensing visit.

LPA's toured the facility today 04/28/2022 at 9:45 AM and the following was observed:

Facility contains 4 Client Bedrooms and 2 Bathrooms, dining room, living room, TV room, and activity room.

Locked storage area for central storage of medications is available.

Walls, ceilings, floors, carpeting, window screens, and areas around the facility are clean, painted and/or in good repair.

Locked storage area for poisons, toxic, cleaning solutions, and disinfectants.

Doors, stairways, and passageways are unobstructed.

An emergency exiting plan and emergency phone numbers posted in an appropriate place.

An operating telephone on the premises and available to clients.

First aid supplies, which include sterile first aid dressings, bandages, adhesive tapes, scissors, tweezers, thermometer, antiseptic solution, and a current first aid manual is maintained.

Appliances such as microwaves, refrigerators, stoves, etc. are clean and operating properly.

Furniture is room/client appropriate, clean and in good repair.

Each client has an adult bed with mattress, pad, bedsprings, and pillow, which are clean and in good repair.

Each client has an adequate dresser and closet space for clothing and other belongings that includes at least 2 drawers or 8 cubic feet of dresser space.

A sufficient supply of linens to permit weekly changing or more often to insure clean linen at all times for clients. Equipment and supplies for client personal hygiene is available and on site.

Hot water temperature measured 117 F. in both client restrooms meeting Title 22 Regulations.

Physical Plant met Title 22 requirements. Component 3 conducted at today's visit.