Facility Evaluation Report

Licensing Program Analyst (LPA) Fred Arias made an unannounced visit for the purpose of conducting a Plan of Corrections Inspection for deficiencies issued on September 18, 2025 during a case management visit. LPA was greeted and granted entry by staff and discussed the purpose of the inspection.

LPA toured the facility with staff and observed the refrigerator and exit doors accessible. Administrator Emma Han emailed LPA on September 19, 2025 in-service training conducted to correct the deficiencies and updated LIC500 showing updated coverage to provide R1 with one on one supervision and supervision policy. LPA observed R1 with a caregiver and a home health representative. The Plan of Corrections has been fulfilled by the assigned POC due date of September 19, 2025, thus clearing the Type A deficiencies CCR 87468.1(a)(3), 87468.1(a)(6), and 87411(a).

This report was discussed with the facility representative and a copy was provided.