Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection visit to follow up on corrections identified during visit on 12/15/2023. LPA arrived at the facility and was greeted and granted entry by Licensee Yung Lee and designated Administrator (AD) Young Park. An application to operate a Residential Care Facility for Elderly (RCFE) for (6) capacity, (0) ambulatory, (6) non-ambulatory, and (0) bedridden residents was received by CCL on 09/01/2023. The facility is a two-story house with three resident bedrooms, three bathrooms, living room, kitchen, dining area, office, laundry room, family room, and attached two car garage downstairs; upstairs is a staff bedroom with a bathroom. Facility also has an additional dwelling unit (ADU) in the backyard, ADU is a studio with one bathroom.

At 9:00 a.m. LPA toured the facility and observed the following:

· There is now lighting in three out of three resident bedrooms, and in the activity room.

· Water temperatures tested at 111.2 degrees F.

· Facility is two-stories, and second story consists of master bedroom for staff, facility has a signal system that is audible and identifies resident’s bedroom.

· Downstairs master bedroom 3 has a chest of drawers, and chairs for residents.

· All resident beds have the required elements including blankets and bedspreads.

· Visiting policy is posted at the entrance of the facility.

· Drawers and lock on file cabinet for medication are operable.

· Five out of five gas stove burners are operable and refrigerator in garage has been removed from the facility.

All noted items from visit on 12/15/2023 have been addressed. The facility is ready to be licensed. An exit interview was conducted and a copy of this report was left at the facility.