Facility Evaluation Report

Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced on 3/16/2022 at 8:50 AM to conduct a Pre-licensing CHOW inspection. Prior to entering the facility, LPA Truong called the facility and spoke to staff, who confirmed no residents or staff have had any symptoms of COVID-19 in the last 10 days. Upon LPAs arrival, Caregiver Rose Nadonza was present at facility and contacted current Administrator Jennylind Duran who arrived a bit later. LPA was screened for COVID-19 symptoms and temperature taken prior to entering the facility. LPA met with Applicant Maria Kang and current Administrator Jennylind Duran and explained the purpose of the visit. Applicant Maria Kang assisted with today’s visit.

Applicant Maria Kang holds a current certificate # 6020167740 which will expire on 09/02/2022. LPA toured and inspected the physical plant inside and outside with Applicant Maria Kang to ensure there were no health and safety concerns on 3/16/2022 at 9:20 AM. LPA observed there were six (6) residents in care at this time.

LPA observed the kitchen area, dining area, bedrooms, bathrooms, storage areas, and laundry area. LPA observed knives/sharps area to be locked. LPA observed required furniture, and lighting throughout the facility. The hot water temperature was measured at 118.9 degrees Fahrenheit which is within the required range of 105-120 degrees Fahrenheit. The temperature inside the facility measured at 70 degrees Fahrenheit which is within the required range of 68-85 degrees Fahrenheit. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises. The first aid kit was up to date.