Facility Evaluation Report

Licensing Program Analysts (LPAs) Mita Partoza and Marcella Tarin conducted a POC case management visit to clear deficiencies cited on October 2, 2025 and October 9, 2025, during a case management / Complaint investigation visit. LPAs met with Administrator (ADM) Xi-Hua (Julia) Luo and stated the purpose of the visit.

The facility was cited the following deficiencies on October 2, 2025 with the following POC dates and is being cleared today:

• 87468.1 Personal Rights of Residents in All Facilities (a) Type A- POC due date October 3, 2025. Plan of Correction received on October 9, 2025.

• 87202 Fire Clearance (a) -Type A, Issued CP of $800.00 beginning October 9, 2025, and will continue to accrue until corrected.

• 87755 Inspection Authority of the Licensing Agency (a) - Type A, Issued initial CP of $800.00 beginning October 9, 2025 and will continue to accrue until corrected.

The facility was cited the following deficiencies on October 9, 2025, with the following POC date and is being cleared today:

• 87625 Managed incontinence (b)(2), Type A – POC due date October 10, 2025. Plan of Correction received on October 9, 2025.