Facility Evaluation Report

Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to conduct a pre-licensing inspection with Licensee, Karen Lim. This application is a change in ownership. The facility has a fire clearance for six (6) non-ambulatory residents.

LPA and Licensee conducted an inspection of the care home to ensure compliance with Title 22 regulations. Areas toured included but not limited to: common area, kitchen, bathrooms, bedrooms, laundry room, backyard, storage room. There are two (2) shared resident bedrooms, two (2) private resident bathroom and one (1) shared bathroom for resident use.

LPA observed facility to be properly furnished, including appropriate bedding and lighting in bedrooms. LPA checked the kitchen area for the ability to prepare and store food. LPA observed at least a 2-day perishable and 7-day nonperishable food supply at the facility. LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors at the care home are operational.

LPA and Licensee completed the Pre-licensing care tool together and at this time facility is found in substantial compliance.

Component III was completed with Licensee.

Exit interview conducted with Licensee, and a copy of the report was left at the facility.