Facility Evaluation Report

Unannounced Annual Inspection visit was made by Licensing Program Analyst (LPA) Kimberly Viarella to this facility on 10/15/25. LPA identified, explained the purpose of the visit, and met with the Licensee/Administrator, Namjung Cho. A brief interviewed followed. Currently there was one resident in care.

The facility license was posted: this facility was licensed for a capacity of 6 non-ambulatory and was granted a hospice waiver for 2. LPA noted the Administrator/Licensee, certificate, # 6069747740 expired on 04/21/26.

LPA observed that the required facility sketch, and Emergency /Disaster plan, were posted along with Resident Rights and the Ombudsman information and "If You See Something, Say Something," poster.

The inspection began in 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 pantry items had visible expiration dates. LPA provided technical assistance on dating containers in the refrigerator with the date the item was opened or repackaged.

LPA inspected the 3 resident bedrooms and 2 staff bedrooms. All resident rooms had the required furniture, furnishings and lighting to be in compliance at this time.

LPA noted soap, paper towels and trash cans with lids in the bathrooms. The hot water temperature was measured at 109 degrees Fahrenheit and was in compliance. The fire extinguisher was last inspected on 04/08/25 by River City Fire Equipment Co. was were also in compliance.