Facility Evaluation Report

Licensing Program Analyst (LPA) Santino Fortes conducted an unannounced annual inspection, and met with Licensee (LC) Ying Wang. LC stated facility has 3 staff and 5 clients.

LPA toured the facility inside and out. There were 6 resident rooms (single), 1 staff, 1 dining, 1 Sun room, and Kitchen. LPA observed resident rooms each equipped with a chair, 1/2 bed rail, night stand, sufficient lighting and chest of drawers. Room temperature was 69.4* F. Hot water temperature was measured from resident bathroom at 118* F 118* F and kitchen 119* F. LPA observed the first aid kit to be complete. Smoke and carbon monoxide detectors functioned properly when tested. 2 Fire extinguishers were serviced on 10/10/24. Staff conducted a fire drill on 12/23/2024. Restrooms observed to have non skid flooring. LPA observed 2 days perishable food supply and 7 days non-perishable food supply. Refrigerator temperature observed at 48 * F and Freezer temperature 8*. LPA observed medication storage, knives storage, and cleaning product storage locked and inaccessible to clients in care.

The front & back yards were inspected. Exits and walkways were unobstructed. Facility has 1 storage shed that stored walkers, care facility supplies and office supplies. Garage was observed as supply storage.

LPA observed Facility License and Resident Personal rights were posted. LPA reviewed facility records for 3 staff, 5 clients and observed to be complete. LPA reviewed 5 client’s medications, centrally stored medication records and observed to be complete. Facility does not manage resident cash resources.

No deficiencies were cited during today's visit as per California Code of Regulations Title 22. Exit interview was conducted with LC. This report was reviewed and a copy was provided to LC for signature.