Facility Evaluation Report

Announced one year required visit made out to this facility by Licensing Program Analyst (LPA) Jason Lund who was met by the Administrators, Susan Xiong, and Yer Xiong. LPA Lund explained the reason for the visit. Census: 0

LPA Lund & Administrators, Susan Xiong, and Yer Xiong tour/inspected of the facility kitchen area. Kitchen drawers and cabinets were reviewed. It was observed that there was a sufficient supply of plates, cups, and other dinnerware/flatware made available to meet the needs of the residents at this time. Knives and other sharp objects were observed to be stored in a manner that was locked and made inaccessible to clients. First aid kit was observed to be stored in this location at this time. All required components for the first aid were observed to be present and in compliance at this time. Sample copies of the facility resident files were observed to be present at this time. Sample copies of the facility staff files were observed to be present at this time.A review of the facility Medication Administration Record was conducted at this time. Inspection of the dining area, living area, and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time. Fire extinguisher, located in the kitchen area, was observed to have been annually inspected by the local fire extinguisher company, Armor Fire, on 09/09/2025 and in compliance at this time. Inspection of the resident bedrooms (4) was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time.

No Deficiencies were cited during the visit and report left.