Facility Evaluation Report

Licensing Program Analysts (LPAs) Steve Chang and Simi Rai conducted an unannounced Case Management - Legal/Non-compliance inspection and met with Administrator (ADM) Xiuyan Chen.

The purpose of the visit is to ensure that facility is adhering to the Compliance Plan submitted to Community Care Licensing (CCL) after a Non-Compliance Conference held on 03/28/23.

LPAs discussed with ADM regrading the plans of preventing lack of supervision and care on residents, ensuring staff are available 24 hours/ 7 days, updating Administrator Certificate, understanding of the personal rights, ensuring adequate staff necessary for residents' care and supervision, and updating facility's emergency plan. LPAs discussed with ADM for updating facility policies and procedures of the standards for the facility operations. LPAs discussed with ADM to maintain resident files and staff files.

LPAs toured the facility inside and out with ADM and checked/inspected for the storage of disinfectants, two extra storage rooms, restrooms and resident bedrooms, and the garage. LPA checked the facility LIC 500 and the Administrator Certificate. Two days perishable food supplies and seven days non perishable food supplies were observed sufficient.

LPAs discussed with ADM regarding providing staff training with observation and assessment of residents, personal rights, and mandatory reporting. LPA obtained documents regarding the facility's written plan to address the prior deficiencies.

See Page 2 of 2, continuation page 809-C.