Facility Evaluation Report

On 6/23/2026, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct the Annual 1-year required inspection. LPA Calandra was greeted by Ping Jing Zhao, Administrator/Licensee and explained the purpose of the facility.

LPA toured the physical plant. This facility is a 1-story building with 6 bedrooms(5 for residents and 1 for staff), 6 bathrooms, a kitchen, dining room, living room, office, garage, and front and backyards. No accessible bodies of water or hazards were observed. All bedrooms had the required furniture and sufficient lighting. All bathrooms had anti-skid flooring and grab bars. The facility's hot water temperature was within the required 105-120 degrees Fahrenheit. The facility's fire extinguisher was observed to be fully charged and last checked on 4/2/2026. The facility had the required 7 days of perishables and 2 days of perishables on hand. No food was expired. The facility's first aid kit had all of the required items.

All sharp objects, soap, detergents, and poisons were observed to be locked and in-accessible to persons in care.

LPA reviewed 4 resident files and 5 staff files. All were observed to be complete.

LPA requested the facility send the following documents by 6/30/2026: LIC 500(Personnel Summary Report), Current Liability Insurance.

A review of Centrally Stored Medications indicated that medications for residents were properly labeled with

During file review, LPA Calandra observed that the facility did not have documentation of their quarterly emergency drills. A Type B citation was issued for this deficiency.

instructions on dosage and times of day and matched the Centrally Stored Medication Records(CSMR) kept at the facility.

Deficiencies are cited under the California Code of Regulations. Failure to correct the deficiencies by the POC due date may result in Civil Penalties.

An exit interview was conducted. A copy of the report along with Appeal Rights were provided to the Administrator/Licensee.