Facility Evaluation Report

On 10/06/2025, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Annual Visit to the facility listed above. LPA met with Licensee Ke Sun, and the purpose of today’s visit was explained. LPA was granted entry into the facility. The facility is licensed to serve six (6) non-ambulatory residents aged 60 and over and have an approved hospice waiver for four (4).

Physical Plant The facility is a single-story home in a residential neighborhood. The home consists of four (4) resident bedrooms, staff room, three (3) bathrooms, living room, sitting room, office area, kitchen, laundry room, detached garage, front and back yard. LPA observed a shaded patio with table and chairs. All windows and screens were observed clean and in good repair. LPA observed all walkways around the facility are clean, clear, and free of debris, hazards, and obstructions. All fences open easily from the inside to exit. The facility does have a fireplace that is screened and inaccessible to residents.

Bedrooms LPA inspected all resident rooms and observed them to be clean and in good repair. LPA observed the rooms have the required furniture including a bed, dresser, nightstand, chair, and storage space for personal belongings. LPA observed the beds have the required linens including a mattress cover, fitted sheets, blanket, comforter, and pillows. LPA observed a supply of linens in a cabinet in the hallway. All linens and mattresses were observed in good repair. All bedrooms were observed to have ample lighting.

Bathrooms LPA inspected all bathrooms and observed them to be operable and within Title 22 regulations. The toilet, facets, and shower work properly. The bathrooms were observed clean and showers free of mildew and mold. The showers were observed with secured safety handrails, nonskid mats, and a shower chair. LPA observed storage space for residents’ hygiene products. LPA observed an ample supply of towels in a cabinet in the hallway. LPA observed a supply of hygiene products available for residents in a closet at the entrance of the facility. The water temperature measured between 112.3 -degrees, 111.4- degrees and 115.6 -degrees Fahrenheit.