Facility Evaluation Report

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Jumsoo Kim, Licensee, and discussed the purpose of the visit.

The facility is a Residential Care Facility for the Elderly (RCFE). License capacity of (6) clients with a current census of (5). Hospice waiver for (4). LPA conducted an overall inspection of the facility, which included, but was not limited to, the following:

LPA inspected the facility inside and out. Indoor and outdoor passageways are free of obstruction. The facility has sufficient lighting and is maintained at a comfortable temperature. Facility has no outdoor bodies of water. Backyard is fenced with self-latching gates. Facility has a covered outdoor patio area sufficient for clients in care.

LPA inspected the kitchen. The refrigerator and freezer are operating in a healthful manner. Hot water temperature is maintained at 105 degrees F. Facility has sufficient non-perishable and perishable food supply for clients in care. Facility has sufficient cups, plates, and utensils for client use. Facility food is stored in a safe and healthful manner.

LPA inspected client bedrooms. Bedrooms are equipped with beds, linens, nightstands, chairs, and sufficient storage space and lighting.

LPA inspected client bathrooms. Bathroom equipment is operating in a safe and sanitary condition. Bathroom hot water temperature tested at 105 degrees F.