Senior Care Records.

Facility Evaluation Report

Kasa Jomi, South San Francisco01/20/2026Licence 415601109

Capacity4
Census4
Date signed01/20/2026 07:32:02 PM
Name of licensing program analystGrace Donato
Name of licensing program managerBrenda Chan
The inspector’s account

On 1/20/26, LPA Grace Donato made an unannounced annual visit to the facility. LPA met with Administrator Carolyn Dizon. LPA explained the purpose of the visit.

LPA toured the facility inside and outside including all of resident rooms, garage, and kitchen area. LPA observed residents arriving from day program. While touring the facility it was observed that the room temperature was at 70 deg F. The facility is observed to be clean, odorless, and well maintained. Residents bedrooms were observed to be well organized and fully furnished with adequate lighting. Sharps and toxic materials were observed to be locked. Food supply was observed with an adequate two day perishable and seven day non-perishable food supply. Carbon monoxide/ smoke detectors, and fire extinguisher were present throughout the facility. Facility has an updated log for emergency drill which is done every quarter.

Four resident records and three staff records were reviewed. Resident’s PNI money was counted and all accounted for. Staff have criminal record and fingerprint clearances on file. Staff have current First Aid/CPR certifications on file. Resident records were reviewed and were observed to be complete. All medication logs are complete and updated.

LPA received a copy of the Liability Insurance and updated LIC500.

No deficiencies are cited at this time. Report is reviewed and a copy is provided

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction