Facility Evaluation Report

Licensing Program Analysts (LPAs) Tao and Mallett conducted an unannounced annual visit at the facility using the CARE inspection tool. LPAs met with Staff#1 upon arrival and Administrator Jeffrey Yang join shortly after. LPAs explained the reason for the visit to Administrator. Facility annual fees are current. Liability insurance coverage is current which covers from 06/28/25 – 06/28/26.

This facility is licensed to serve six (6) non-ambulatory residents, age 60 and above and have one (1) hospice waiver approved. Dementia waiver is in place.

Today’s inspection consisted of applying CARE tool, conducting physical plant, reviewing staff/residents records, checking residents’ food supply/medication, and interviewing staff/residents.

Facility maintains an infection control plan was on file. Staff were observed practicing safe hand washing. Hand sanitizing was observed throughout. Hygiene supply and sanitizing materials were observed in each bathroom and changing station.