Facility Evaluation Report

At approximately 8:30AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a 1 Year Required visit and met with Staff Members, Elsa Bacsal and Mary Wang. Administrator, Tom Yuan, arrived during visit at approximately 9:00AM. Licensee, Sherry Zhu, arrived during visit at approximately 9:20AM. Facility is a Residential Home for the Elderly that provides care and assistance for Older Adults with Disabilities. Facility has an approved fire clearance and capacity for 4 Non-Ambulatory Residents. Facility has a hospice waiver for 1 individual. Upon arrival, LPA was informed that there were 4 residents in care, with 2 residents preparing to leave for their Day Program. LPA was also informed that there were 2 staff members on site.

At approximately 8:45AM, LPA reviewed the Facility's Staff Roster and found that all staff on site were background cleared and associated to the facility per regulation. LPA conducted a walk-though of the facility with Administrator. LPA observed the following: Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a one story building with 4 resident bedrooms, 2 bathrooms, and common spaces. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Mattress pads were in place or available for resident use. Toxins were observed to be stored inaccessible to residents. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit. During walkthrough, LPA observed that facility had multiple instances of expired foods in facility fridge and freezer including tofu and Costco prepared meals. LPA, Administrator, Licensee discussed checking foods to ensure that food stays safe for consumption. Administrator's Certificate for Tom Yuan (7003584740) was current with an expiration date of 05/19/2026.

Fire extinguishers were last inspected June 2026. Smoke detectors and carbon monoxide detectors were tested and operational. Facility's last emergency/disaster drill was conducted July 2026. Facility's emergency disaster plan was last reviewed and updated May 2025 and infection control plan were last reviewed and updated June 2025. Facility did not have