Facility Evaluation Report

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a Required Annual Inspection and met with Licensee/Administrator Jun Zheng. Clients were attending to day program.

LPA initiated a tour of the facility at 12:15 pm and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Client rooms were furnished per regulation. Water temperature in client's bathroom measured at 117.8 and 119.7 degrees F which are within allowable range of 105 to 120 degrees F. Extra hygiene products and linens were available. Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored in a locked cabinet located in living room. Toxins were locked in a closet located in the hallway. Knives were in a locked box located in the kitchen. Fire extinguisher was last inspected 11/2022. Smoke detectors located throughout the facility were tested and operational. Carbon monoxide detector was tested and operational. Licensee was unable to provide proof of last disaster drill conducted within the last quarter. Clients handle their own cash and have bank accounts. Outstanding annual fees are pending for this facility. On 9/22/23 LPA sent an outstanding email to Licensee to pay fees, but they are still pending as of today. Menu/activities reviewed.

File review was initiated at 1:00pm. 4 residents and 3 staff files were reviewed. However, one out of four resident's individual personalized plan have not been updated within the last 12 months. Four out of four clients file didn't have medical assessment on file. Per Licensee, all resident's medical assessments are in their other facility. Three staff files were reviewed. Three out of three staff files didn't have training hours on file, but their CPR/1st aid were current. Administrator Certificate for Licensee Jun Zheng 6030306735 expired on 1/8/23. However, Administrator provided proof that their administrator certificate is still pending in the system. Required postings were observed. Licensee to submit updates of the following documents by 11/1/23: Designation of Administrative Responsibility (LIC308), surety bond & Personnel Report (LIC500).

Deficiencies cited from the California Code of Regulations, Title 22. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Licensee and a copy of this report was given.