Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen conducted a Pre-Licensing visit to observe the facility’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. LPA was greeted by, identified himself to, and explained the purpose of the visit to the applicant’s representative, Henrietta "Candy" Chong.

The facility fire clearance was granted on 02-27-2024 and reflected that the facility was approved for six (6) clients in total, of which three (3) may be non-ambulatory and one (1) may be bedridden. Per the facility sketch, Bedroom #2 was approved for non-ambulatory, and Bedroom #1 was approved for bedridden or non-ambulatory. During today's visit: There were six (6) clients in care, of which two (2) were non-ambulatory and residing in the correct bedrooms. No current clients were bedridden. The facility's fire clearance did not include endorsements for delayed-egress doors or secured perimeter, and neither were present during today's visit. The submitted facility sketch was consistent with the current layout of the facility.

During today’s visit, LPA, accompanied by the applicant’s representative, toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were well lit and free of obstruction and slip hazards. Client bedrooms allowed for easy passage and contained the required furnishings. Toilets, sinks, and showers were in working order. The facility’s ambient internal temperature was complaint at 75 degrees F. Hot water temperature at taps accessible to clients were also compliant: Kitchen sink was 119.7 F, Bathroom #1 sink was 116.2 F, and Bathroom #2 sink was 109 F.

The facility has enough linens, hygiene supplies, cooking and dining supplies, and perishable and non-perishable food for client use. All kitchen appliances were in working order. Kitchen Refrigerator temperature was 38 F, and Kitchen Freezer temperature was -1 F. Garage Refrigerator temperatures were 39 F and 39 F, respectively. Garage Freezer temperatures were 0 F and 0 F, respectively. [CONTINUED ON LIC 809-C]