Facility Evaluation Report

Unannounced Annual visit made out to this facility on 03/30/2026 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility staff person at this time. A brief interview was conducted with the facility staff person at this time. This LPA requested that she go ahead and contact the facility designated Administrator, Aaron Tan, to inform him that CCL was present at this time. The co-Administrator, Cleo Tan, was present at this time.

It was learned that this facility was vendorized to be able to accept and retain up to (4) Level 6 residents at any given time. This facility was licensed to serve up to (6) residents, of which (2) can be Non Ambulatory, at any given time. Current census was 2 residents, of which (1) of them, was out of the facility at their respectable day program at this time.

A tour of the facility kitchen area was conducted. Drawers and cabinets were opened and the items enclosed were reviewed at this time. Drawers housing knives and sharps were observed to be locked and made inaccessible to the residents at this time.

Cleaning agents, bleach, and other supplies which were stored in a closet and were observed to be locked and made inaccessible to the residents at this time.

A review of the facility food supply was conducted. A review of the facility's 2-day perishable foods and 7-day nonperishable foods was conducted to make sure that there were sufficient quantities on hand at all times.

Medication cabinet, located in the facility kitchen cabinet, was reviewed. Policies and procedures involving handling, dispensing, and documentation of the resident medications were discussed with the facility staff persons present at this time.

A review of the facility Medication Administration Record and dispensing log was conducted.