Facility Evaluation Report

Licensing Program Analyst (LPA) Nicol Wesley conducted an unannounced Required 1 year inspection at the facility and met with Administrator Lolita Tan and explained the purpose for todays visit. Prior to the visit LPA Wesley conducted a risk assessment for on-site inspections. The facility phone number is 562 864 7814. .

The facility consist of four bedrooms(two for residents), relaxation area, two bathrooms( one for residents), living room, office, dining room, TV room, kitchen and covered storage area, back yard, with attached garage(washer and dryer).

During the visit the Infection control domain was used and the following areas were observed/inspected: The facility had all postings at the front entrance, bathrooms, and throughout the facility. Hand sanitizing gel and masks were located at the entry of each room. A Pre screening area with PPE supplies was observed upon entry into the facility. The facility mitigation plan was reviewed and approved on 04/09/2021.

LPA conducted a complete tour of the facility, and observe the supply of food. Resident medications, and medication logs were reviewed. The smoke detectors/carbon monoxide detector are operable. LPA observed one fire extinguisher located in the kitchen. The water temperature was tested and measured 118.7 degrees F.