Facility Evaluation Report

Unannounced Annual Inspection visit was made by Licensing Program Analyst (LPA) Kimberly Viarella to this facility on 12/19/24. There was no one present at the facility - staff and 1 client were out doing and errand and the other 2 clients were at a day program. LPA contacted the Administrator. The Administrator along with the staff and client running errands, arrived shortly afterward. LPA identified herself upon arrival, stated the purpose of the visit. LPA met with Sally Wong and a brief interview followed. LPA requested the following documents:

· LIC 308: Designation of Administrative Responsibility

· LIC 309: (for any LLC or Corp) if applicable

LPA noted the Administrator's certificate # 7034029735 and it expires on 08/16/26.

LPA inspected resident rooms. All rooms were single occupancy and had the required furniture furnishings and lighting to be in compliance at the present time. The doors to all of the rooms were also equipped with locks for residents to use if they so chose.

The LPA inspected the kitchen. All knives and sharps were locked and inaccessible to residents in care. The food supply was adequate for 2-day perishable and 7-day nonperishable. All food items were dated, labeled, and stored according to regulations.

LPA inspected the bathrooms. Each contained soap, paper towels, and trash cans as required. Personal hygiene items were present, toxic cleaning supplies were not. Hot water was measured to ensure the temperature was between 105 and 120 degrees Fahrenheit in order to be in compliance.