Facility Evaluation Report

On December 22, 2025, Licensing Program Analyst (LPA) Garlli Tat made an unannounced visit to conduct a case management visit to follow up on deficiencies cited. LPA was greeted and granted entry by staff on duty. LPA stated the purpose of the visit. Staff on duty notified Administrator Ngoc Mai.

The purpose of the case management visit was to revisit the deficiencies noted on November 24, 2025.

Administrator called the social worker to follow up on the TB test for Resident #2. The social worker confirmed the TB test is negative and reported they would bring the results to the facility today. The request was sent to the PCP on December 10, 2025.

Administrator reported he will fax the emergency disaster drill today. LPA reminded administrator that he should send it no later than December 24, 2025.

Admission agreement for Resident #3, CPR certification for Staff #2, and 20 hours of training for Staff #2 have been received via email.

An exit interview was conducted with the administrator and a copy of this report was reviewed and provided at the end of the visit.