Facility Evaluation Report

At 8:00am on 03/25/2024, Licensing Program Analyst (LPA) Jeffries arrived unannounced to the facility to conduct the annual facility inspection. LPA met with Administrator Junsik Kim, announced who he is and the reason for the visit.

Administrator and LPA conducted a physical walking tour of the facility. LPA noted that this is 5 bedroom and 2 bathroom facility. Each client has their own room and all share one bathroom. The master bedroom is a staff room and has an on suite bathroom for staff. The outside has seating and a pergola for shade. There are working smoke detectors throughout the facility and a working carbon monoxide detector in the lving room/dining room area. There is a working fire extinguisher in the dining room. Medication is locked and stored in a locked cabinet in the kitchen. First Aide kit is located on the stand in the dining room where the PPE is located. LPA noted that all client bedrooms have all regulated furniture, linin, and bedding. LPA noted that there is at lease 2 days of perishable foods and at least 7 days of non perishable foods on hand for 4 clients and staff. LPA noted that the facility is clean and in good repair. LPA observed required postings on the wall in above the dinning room desk. LPA noted that the facility is clean and in good repair. LPA noted that the facility is operating within the regulation of their fire clearance. LPA noted that all walkways, halls, and door ways are free and clear of debris and obstacles. LPA noted that staff and clients files were reviewed and had no observe issues. LPA conducted a sample review of the centrally stored medication record (CSMR) and noted no observed issues. LPA noted that there were no technical, violations, or citations issued as a result of the facility physical walk through inspection.

Administrator and LPA conducted a full review of the facilities annual control tools modules and noted that there were no technical, violations, or citations issued as a result of the annual facility inspection, full control tools modules. LPA note that the full facility annual inspection that there were no technical, violations, or citations issued.

Exit interview, report read, and report provided.