Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen made an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Licensee/Administrator Josefina So.

According to the facility’s license, the facility has a maximum capacity for four (4) clients, of whom all may be ambulatory or non-ambulatory, but none may be bedridden. Per LPA observation and manager interview: During today’s inspection, there were a total of zero (0) clients in care. The facility’s license does not include endorsements for delayed-egress doors or secured perimeter doors, and neither of these were present. LPA, accompanied by the Licensee/Administrator, toured the interior and exterior of the facility, and inspected all common areas and bedrooms. LPA also reviewed personnel and administrative files.

The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were working. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was complaint at 74 F. Where tested, hot water temperature at taps accessible to clients were compliant. Appliances to preserve perishable food were also compliant in temperature. Cooking/dining equipment and utensils were present and in good condition.