Routine inspection·April 30, 2025

On 4/30/2025 at 9:30am, 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 including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of four (4) 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 72 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 106.4 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 is not posted. First aid kit was observed to be complete. LPA reviewed two (2) staff files and all three (3) resident files which were all complete. Continued on LIC809C. 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 · Liability Insurance LPA observed the following deficiencies: At 2:44pm, LPA observed slow water flow, chipped, cracked and rusted tile in bathroom #1. At 2:55pm, LPA observed back yard porch ladder, bed frame, mattress, commodes, end table, lamp, bed rails, ladder, sink, washer, walker, paint buckets, toilet, chairs, cart, fan, bricks, gas can, At 3:05pm, LPA observed no screen on back sliding door. At 3:15pm, LPA observed cobwebs and dirty curtains on the large window/sliding back door. At 3:20pm, LPA observed a leak under the kitchen sink. The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of appeal rights and this report provided.