Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with House Manager (HM) Ernie Manaois.

LPA reviewed 5 resident files and 3 staff files.

LPA toured the facility inside out with HM. License, Administrator Certificate and personal right poster were observed in the office, HM stated the facility will post them at the main entrance. Family room, dinning room, kitchen, office, 4 resident single rooms, 3 resident shared rooms, and 3 restrooms were inspected. The screens of 3 resident bedrooms were observed not in a good repair. There was no night light at the facility hallway. Room temperature was at 72 degree F, and hot water temperature was at 106 degree F. The temperature of the refrigerator was measured at 40 degree F, and the temperature of the freezer was measured at 0 degree F. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Knives closet, medication closet, and cleaning product closet were observed locked. The facility is equipped with smoke and carbon monoxide detectors. HM tested the smoker detectors, and they were working fine. Fire extinguisher was serviced on 7/12/2023.

LPA inspected the facility records, it shows the facility had emergency and fire drill on 10/30/2023.

Front yard and backyard were inspected. There was no obstruction to block the walkways.

Citations were noted today. See LIC9099-D. Exit interview was conducted with HM. A copy of this report was provided to HM.