Facility Evaluation Report

Unannounced Annual visit made out to this facility on 05/14/2026 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator, Mai Xiong, at this time. A brief interview was conducted with the facility designated Administrator at this time.

It was learned that this facility was vendorized to be able to accept and retain up to (4) Level 6 residents at any given time. This facility was licensed to serve up to (4) Ambulatory only residents at any given time. Current census was 3 residents, of which all (3) of them, were out of the facility at their respectable day programs at this time.

A tour of the facility kitchen area was conducted. Drawers and cabinets were opened and the items enclosed were reviewed at this time. Drawers housing knives and sharps were observed to be locked and made inaccessible to the residents at this time.

Cleaning agents, bleach, and other supplies which were stored in a closet and were observed to be locked and made inaccessible to the residents at this time.

A review of the facility food supply was conducted. A review of the facility's 2-day perishable foods and 7-day nonperishable foods was conducted to make sure that there were sufficient quantities on hand at all times.

Medication cabinet, located in the facility kitchen closet, was reviewed. Policies and procedures involving handling, dispensing, and documentation of the resident medications were discussed with the facility designated Administrator at this time. A review of the facility Medication Administration Record and dispensing log was conducted with the facility designated Administrator since this facility employed an E-MAR system at this time.