Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Cecilia Claridad. LPA toured the facility inside and out with ADM.

License and personal rights posters were observed in the facility. Administrator Certificate was observed expired, ADM provided document to show he/she already renewed the Administrator Certificate. 2 residents and 2 staff were observed in the facility. LPA reviewed 3 resident file and 3 staff files. Two medications of a client C1's centrally stored medication form without staring date.

Family room, living room, kitchen, dining area, 2 restrooms, a office, one staff room and garage were inspected. 3 single resident bedrooms and 1 resident shared bedroom were inspected. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. The temperature of the freezer was observed at -2 degree F, and the temperature of the refrigerator was observed at 40 degree F. Medication closet, knives closet, and chemical closet were observed locked. Room temperature was at 73 degree F, and hot water temperature was at 105 degree F in facility. Fire extinguisher was serviced on 4/15/2025. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Carbon monoxide detectors were tested by ADM, and were working. First aid box, night lights, and flash lights were observed in the facility.

Front yard and backyard were inspected. There was no obstruction to block the walkways. A storage room was observed at backyard. The last time the facility conducted the emergency and fire drill was on 4/25/2025.

Deficiency noted today. See LIC809-D. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the report was provided to ADM.