Facility Evaluation Report

On 4/4/22 at 9:40am Licensing Program Analyst (LPA) Maja Jensen arrived announced to conduct a required one year annual visit. LPA Jensen met with Licensee Ming Him Chan and explained the purpose of today's visit. LPA Jensen was screened for COVID at the entrance of the facility and allowed access the premises. Licensee Ming Him Chan holds current Administrator's certificate # 6047821735. There are currently no clients residing at the facility.

The facility is a single story structure with wheelchair accessibility. LPA Jensen observed all required signage, including COVID related, to be prominently posted. LPA toured the facility indoors and outdoors including but not limited to dining room, living room, kitchen, garage, 2 bathrooms, 4 bedrooms and backyard. The facility is licensed for 4 clients of which 1 can be non-ambulatory. One bathroom is for clients and has sufficient space to accommodate a non-ambulatory client and one bathroom is for staff.

The facility was observed to be adequately furnished and sanitary. The facility temperature was set at 70 degrees which is within the required range of 68-85 degrees. The water temperature in the bathroom was measured at 106.6 which is within the required range of 105-120 degrees. The fire alarm and carbon monoxide detectors were tested and observed to be in good repair. The fire extinguisher was purchased on 4/17/21 and is in compliance.

The kitchen was observed to have locked storage for sharp objects and toxins. Two first aid kits were observed to be complete. Lighting was observed to be adequate throughout the facility. Night lights were observed to be available throughout the hallways and emergency lighting was available. LPA Jensen observed a 30 day supply of PPE as well as emergency food and water supplies. An activity calendar and meal menu was observed to be posted.

No deficiencies were cited as a result of today's visit. An exit interview was conducted and left with the facility.