Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted and granted entry by Staff Susan Eom. LPA met with Administrator (AD) Daniel Yoo and the purpose of the inspection was discussed.

During the inspection, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following:

This is a two-story house consisting of four resident bedrooms, one staff bedroom, four bathrooms, and attached 2-car garage. The second story consists of a loft used as a storage area. All resident bedrooms had the required furnishings. LPA observed all residents’ beds had linens and blankets. LPA observed residents listening to soft music in the living room. Bathrooms were observed to be free of debris and mildew and faucets and toilets were operational. Water temperature tested at 118.5 degrees Fahrenheit. LPA observed the backyard has a shaded sitting area, swimming pool, jacuzzi, and koi pond. All bodies of water were observed to be enclosed by white fencing and entrance door was observed to swing away from bodies of water, was self- latching, and latch was located within six inches from the top of the gate. Facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulation. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged. Facility appliances were observed to be operable. Medication was observed to be centrally stored and locked. LPA reviewed five of five resident files and two staff files. LPA observed five of five resident files did not include a pre-admission appraisal and AD stated records are not retained other than for the current year; a Deficiency was cited on today’s date.

Based on the observations made during today’s inspection, a deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.