Facility Evaluation Report

LPA Audrey Jeung toured facility and grounds of this Adult Residential Facility for Persons with Special Health Care Needs. No accessible bodies of water or fire safety hazards are observed. There are 4 private bedrooms for residents and 2 common bathrooms. There is a 2 car garage used for storage and wood deck in the backyard. Washer and dryer are located in hallway. Facility employs licensed nurses 24 hours/day to meet the medical needs of residents.

A comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Soap and paper towels are present in bathrooms and kitchen sink, including reminder signs to wash hands. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. Hot water temperature is tested at 112 degrees F. First-aid kit is inspected and complete. An updated Disaster and Mass Casualty Plan is posted. Two residents receive g-tube feeding and 2 residents eat by mouth; perishable and non-perishable food supplies are maintained for all residents. Four residents are present, and 4 staff. Client records are reviewed--including personal and incidental money handling records for 3 clients--and criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as required staff records. Kaila Branch is the administrator (x 4/27) that oversees facility operations.

The following forms/information are requested to be submitted to CCLD by 11/10/25:

No deficiencies of the General Licensing Regulations, of the California Code of Regulations, Title 22, are observed. Facility is operating in substantial compliance. See Technical Advisory Notes--one page..