Facility Evaluation Report

Licensing Program Analysts (LPAs) Cheyenne Ratajczak and Kerry Hiratsuka arrived unannounced at the facility to conduct a required 1-year annual inspection. LPAs met with Executive Director (ED),Lauren Chon and explained the purpose of the visit.

LPA and Staff conducted a tour of the facility. Areas toured included but not limited to: five (5) rooms on the ground floor and four (4) rooms on the second floor, laundry rooms, kitchen, dining room, medication room and common areas. LPA observed residents in the dining room having lunch. The residence was found to be clean, safe, sanitary and in good condition.

LPAs observed the facility to have the mandated posters posted. Fire extinguishers are maintained and ready for emergency use. Facility has required food supplies.

LPAs conducted a record review of ten (10) resident records. Resident records contain signed admission agreements, physician's reports, appraisals, identification sheets, and resident's rights. LPAs reviewed eight (8) staff records. A review of staff records indicates that facility staff has received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current training completed.

LPAs completed the full care tool and no deficiencies was observed.

Exit interview conducted and a copy of the report was provided.