Facility Evaluation Report

On 8/25/2025, Licensing Program Analyst, Arvin Villanueva (LPA) arrived unannounced at this facility to conduct their annual inspection visit. LPA met initially met with staff on duty and explained the purpose of the visit. The Licensee/Administrator Youngsuk Cho (S1) was notified and arrived shortly after.

Overview : Facility is a one-story home located in a residential neighborhood. Facility is licensed to serve up to 6 elderly residents. Per fire clearance, all residents may be non-ambulatory. Facility has a hospice waiver for 2 residents.

Initial Observation: Upon arrival LPA was greeted by staff on duty (S2). Present during this visit were 3 residents in care, with one staff on duty. 1 resident was in the living room area, 1 resident was observed sitting at the dining table doing activity and 1 resident was in their bedroom. LPA observed required posters and facility license at the entrance. Room temperature was at 74 degrees Fahrenheit upon arrival.

Areas inspected include, but not limited to, the kitchen, resident bedrooms, resident bathrooms, living and dining room and outdoor areas. LPA observed the inside of the facility to be clean and in good repair at this time. LPA inspected 4 resident bedrooms and were observed to be equipped with the required furniture and sufficient lighting throughout. 1 resident bedroom is currently vacant. LPA measured the hot water temperature in the 1 of 2 bathrooms to be at 117 degrees Fahrenheit. Both resident bathrooms were observed to be in clean and good repair at this time.

Fire extinguisher was observed in the kitchen/dining area and was last inspected on 7/17/2025. Smoke and carbon monoxide detectors were observed throughout.