Routine inspection·April 30, 2025

On 4/30/2025 at 9:45AM, Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-Year Required inspection. LPA met with Fei Kevin Li, Administrator and explained the purpose of the visit. The Administrator currently holds a certificate (# 7035708740 ) that expires on 07/26/2026. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of six (6) total bedrooms, which one (1) bedroom is occupied by staff, and two (2) bathrooms. No bodies of water observed. A comfortable temperature is maintained at 71 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 120 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 01/30/2025. Emergency Disaster Plan was last posted on 4/30/2025. First aid kit was observed to be complete. LPA reviewed three (3) staff files and three (3) resident files which were all complete . continue on LIC 809C Continue from LIC 809 LPA requested the following documents to be submitted to CCLD by 05/09/2025 . · LIC 308 Designation of Administrative Responsibility · LIC 309 Administrative Organization · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan (last page) · Liability Insurance The following deficiencies were observed during the visit: -At 10:44AM, LPA observed a torn screen door. -At 10:47AM, LPA observed refrigerator and dishwasher is dirty. -At 10:53AM, LPA observed unlocked bleach in the kitchen and a unlocked garage which has Home Defence spray, Raid, Xtra laundry soap, cloralen bleach. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations. Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. A copy of this report and appeal rights provided.