Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced Case Management for Legal/Non-compliance inspection visit. LPA met with Administrator Xiuyan Chen (ADM). LPA observed 2 residents in the facility. ADM stated resident R1 lives in the facility over two years, and resident R2 and R3 just moved in the facility on 4/9/2025. LPA observed license, Administrator certificate, and personal right posters were observed in the facility.

The purpose of the visit is to ensure that the facility is adhering to the compliance plan submitted to Community Care Licensing (CCL) as agreed upon during the Non-Compliance meeting on 3/28/2023. The case management of inspections will be conducted every 3 months for 2 years

LPAs toured the facility inside and out including kitchen, dining room, living room, bathrooms, resident rooms, storage room, garage and exterior perimeters. LPA checked the two extra rooms in the backyard, and both rooms were used as storage rooms. The garage was observed as storage room. Knives closet, medications closet and detergent closet under the sink in kitchen were observed locked. Supplies of drinking water, two days perishable food supplies and seven days nonperishable food supplies were observed sufficient. No chemical were observed in the cabinet with food supplies. The water temperature was measured at 117 degree Fahrenheit. Room temperature was at 73 degree F. The fire extinguisher was serviced on 9/24/2024.