Facility Evaluation Report

LPA Jeung inspected facility to follow up on previous pre-licensing visit of 2/16/23.

1. Visitor log is set up and includes date, time, name, contact number, affirmation of absence of COVID symptoms.

2. COVID signs are posted,prominently, including handwashing reminder signs at bathroom sinks.

3. Thirty-day supply of personal protective equipment (PPE)--gloves, hand sanitizers, gowns, masks, N95s--is observed.

4. Reflective tape has been applied to wood grain stairs to 2nd level as a safety measure to clearly delineate the steps. (Section 80087 Buildings and Grounds)

5. Seven-day supply of non-perishable canned fruits and vegetables is observed. (Section 85076 Food Service)

6. Required information--personal rights as per LIC613 and licensing complaint poster (If you see something, say something)--is posted.

Component III orientation was conducted on 2/16/23.

Facility meets Title 22 physical plant requirements for licensure as Adult Residential Facility for 2 ambulatory adults. Immediate licensure is recommended, pending final approval from Centralized Application Unit.