Facility Evaluation Report

Unannounced Annual visit made out to this facility on 05/01/2025 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility designated representative, Chai Damrichob, who was briefly interviewed at this time. This LPA requested that he go ahead and contact the facility designated Administrator, Orchid Damrichob, to inform her that CCL was present at this time for an annual visit.

The facility designated representative conducted this annual visit along with this LPA and represented the facility designated Administrator at this time.

It was learned that there were (3) residents under the care of hospice at this time. This facility does have an approved waiver to be able to accept and retain up to (5) residents under the care of hospice at any given time.

It was learned that there was (1) resident receiving services through home health at this time.

It was learned that there were (3) residents diagnosed with dementia at this time. This facility does have a program to accept and retain residents diagnosed with dementia at this time.

Dining area, living area, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time.

Linen closet, located underneath the stairway, was reviewed and observed to contain a sufficient supply of towels, sheets, and bedding able to meet the needs of the residents at this time.

Kitchen drawers and cabinets were opened and reviewed.

Food supply for 2-day perishable and 7-day nonperishable quantities was reviewed to make sure that they were in compliance at all times.