Facility Evaluation Report

Licensing Program Analysts (LPAs) Dang Nguyen and Alyssa Ramirez conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPAs were welcomed by, identified themselves to, and discussed the purpose of the visit with Licensee Josefina So.

The facility is currently licensed for a maximum capacity of four (4) clients, of which three (3) may be non-ambulatory. Non-ambulatory clients must be assigned to Bedrooms #1 and #5 on the first floor, as per the facility sketch. On the date of inspection, the facility had three (3) clients in care. Two (2) of these clients were non-ambulatory and both resided in the correct/approved bedroom(s). This facility does not have a secured perimeter or delayed egress doors.

During today’s visit, LPAs, accompanied by the licensee, toured the interior and exterior of the facility and inspected each room. Staff and clients were interviewed, and staff and client records were reviewed. LPAs briefly left the facility to take a lunch break between 12:00 PM and 1:00 PM.

The facility was clean, sanitary, and in good repair. Pathways were well lit and free of obstruction and slip hazards. Client bedrooms contained the required furnishings. There were extra linens and hygiene supplies present. The facility’s ambient internal temperature was 69 degrees F. Doors, windows and screens, toilets, and showers were in working order. Water temperature at taps accessible to clients were complaint: Kitchen was 109 F and Bathrooms #1-5 were also each 109 F. The facility had at least 2 days of perishable food and at least 7 days non-perishable food, as well as required cooking/dining equipment and utensils. Refrigerator temperature was 35 F, and freezer temperature was -2 F.