Facility Evaluation Report

On June 18, 2025, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with the administrator, Luzviminda Tan and LPA explains the purpose of today's visit.

LPA toured the facility inside and out and inspected the living room, dining area, kitchen, bedrooms, bathrooms, and backyard. The indoor and outdoor passageways were free of obstruction. The facility has 4 resident rooms and 4 bathrooms. Furniture and furnishings were observed to be sufficient. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Toilet, hand washing and bathing areas were observed clean and in operating condition. Showers were observed equipped with non-skid mats and grab bars. Comfortable temperature is maintained and lighting is sufficient for comfort.

Central storage for medications, sharps and chemicals were observed to be locked and inaccessible to residents in care.

Hot water temperature in the kitchen and bathroom were measured at 107 degrees Fahrenheit. Fire extinguishers were checked.

A review of (2) resident files was conducted and noted on the LIC 858.

A review of (1) staff files was conducted and noted on the LIC 859.

LPA requested for a copy of the Liability Insurance and a copy of the Administrator Certification to be submitted to CCL by 6/23/2025.

This report is reviewed and discussed with the administrator; a copy is provided.