Facility Evaluation Report

Licensing Program Analyst (LPA) Sakinah Madyun conducted an unannounced continued Annual Inspection visit at the facility using the CARE Inspection Tool.

During today's continued annual visit, LPA observed the following:

Bathroom: Bathrooms #1 and #2 Non-slip mats were located inside the shower. LPA retested bathroom #1 after water adjustment and temperature measured at 111.6 degrees Fahrenheit within the range of 105-120 degrees Fahrenheit.

Kitchen: LPA retested kitchen after water adjustment and temperature measured at 117.8 degrees Fahrenheit within the range of 105-120 degrees Fahrenheit.

Food: Scheduled grocery shopping completed 09/05/25 and food supplies were observed for at least 2 days of perishables and 7 days of Non-perishables.

Staffing- Administrator Certificate for Lan Ly# 7005397735 expires 09/20/2026. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. Four (4) staff were interviewed.

Personnel Records-Training- Staff files are maintained and centrally stored at the facility. LPA observed training records and CPR and First Aid certifications. LPA reviewed five (5) staff files and observed TB results, Health screening, Fingerprint clearance and job application. Administrator’s training on HIV and TB was reviewed and completed 03/22/2025. All the staff files reviewed are within Title 22 requirements.

Client Records : Four (4) client files were reviewed and medications logs. Three (3) clients were interviewed.

Inspection tool completed. No deficiencies are being cited. Exit interview conducted with Lan Ly and a copy of this report was provided.