Facility Evaluation Report

Licensing Program Analyst (LPA) Renee Campbell conducted an unannounced Annual 1-Year Required visit on 01/25/23. LPA met and toured with Administrator, Young Cho who currently holds a certificate (#6056802740) that expires on 07/23/2023.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms of which 4 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 74 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7-day supply of nonperishable and 2-day of perishable foods.

Smoke detectors and carbon monoxide alarms are connected to the fire department. Fire extinguisher was last serviced on March 9, 2022. First aid kit was observed to be complete. LPA reviewed staff record files and the facility has sufficient staffing to provide the services needed to meet the residents’ needs. All staff have current first aid training. LPA reviewed 3 of 3 residents’ files and 3 of four staff files were reviewed.

Updated copies of the following documents were provided to LPA Renee Campbell:

No deficiencies were observed. Exit interview conducted. Appeal Rights and a copy of this report provided.