Facility Evaluation Report

On April 28, 2026, at 2:00 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator Chin-Wen Cheng.

The facility is licensed to operate for six (6) non-ambulatory, of which one (1) may be bedridden and have a hospice waiver for three (3) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, one staff bedroom, three (3) bathrooms, living area, laundry room, dining area, kitchen, outdoor covered seating area in the front yard and backyard, and an attached two car garage.

LPA Kim toured inside and outside of the physical plant with ADMIN Cheng. There were no bodies of water or obstructions in the facility. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident's personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, and Resident Room 5. LPA observed the staff bedroom had an area that was not fully enclosed that contained a bed and red curtain setup. This area was not closed of fwith a fourth wall and door. Staff stated that a staff member was sleeping there Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured between 114.8 degrees F to 117.2 degrees F. A comfortable temperature of 77 degrees F maintained in the facility.