Facility Evaluation Report

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator (ADM) Truong. LPA explained the purpose of the visit.

LPA toured the facility inside out with ADM which included; the Living room, kitchen, dinning area, garage, two restrooms and 3 residents bedrooms. The staff room of the facility was also inspected. Front yard and backyard were inspected. There was no obstruction to block the walkways.

Two day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the locked medication cabinet, locked knives storage cabinet, and cleaning product storage area as locked & inaccessible to residents in care. Room temperature was at 75 degree F, and hot water temperature was measured at 117 degrees F in the bathroom labeled master bath and the hallway bathroom.

Fire extinguisher was serviced in August 11, 2023. The facility smoke detectors was tested by ADM, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on 09/18/2023.

LPA reviewed facility records for 3 staff and 3 residents. LPA reviewed 3 resident medications and centrally stored medication records. LPA conducted interviews with 3 staff (S1 to S3) and 2 residents (R1-R2).

No deficiencies cited during today's visit. This report was reviewed with Administrator Truong and a copy of the signed report was provided.