Facility Evaluation Report

On October 8, 2025, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA met with the administrator, Rachel Belong and the house manager, Ryan Belong and LPA explained the purpose of today's visit.

LPA toured the facility inside and outside including the bedrooms (4 private rooms), 2 full- bathrooms, kitchen, living and dining rooms. All outdoor and indoor passageways were observed to be free of obstruction. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and non-skid mat. Comfortable temperature is maintained and lighting is sufficient for comfort. Furniture and furnishings were observed to be sufficient. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Hot water temperature in the kitchen and bathroom was measured at 108-117 F.

Central stored medication, chemicals, toxins and sharps objects were observed to be locked and inaccessible to residents. Emergency drills, central stored medication, P & I and staff training records were reviewed. Food supplies were observed to be adequate.

Facility is equipped with smoke detectors and carbon monoxide detectors. Fire extinguisher was last serviced May 14, 2025.

A review of (4) resident files was conducted and noted on the LIC 858.

A review of (3) staff files was conducted and noted on the LIC 859.