Facility Evaluation Report

Licensing Program Analysts (LPAs) David Marrufo and Simi Rai conducted an unannounced Required - 1 Year visit and met with Xi-Hua "Julia" Luo.

During visit, LPAs toured the facility inside and out. LPAs toured the kitchen area and observed there to be locked storage areas for sharp objects and medications. LPAs observed the kitchen refrigerator had the following medications stored without being inside a locked container: Medications M1-M4, belonging to R1, and Medication M5, belonging to R2.

LPAs observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days.

During visit, LPAs toured six out of six resident bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. LPAs tested the carbon monoxide and smoke detectors in the hallways and six out of six resident bedrooms and all detectors function properly when tested.

LPAs toured five out of five resident bathrooms. Each bathroom had working lights and available soap and paper towels. The water temperatures in the bathroom sinks ranged from 106 F to 107 F.

LPAs toured the outside areas and observed the outdoor exits were clear of obstructions.

See LIC812-C page for more information. Page 1 of 2.