Routine inspection·December 15, 2023

On 12/15/2023 at 9:35am, Licensing Program Analysts (LPAs) L. Hall and T. Syess-Gibson, conducted an unannounced 1-Year Required inspection. LPAs met with Alexandria Liu, Administrator and LPA explained the purpose of the visit. The facility’s fire clearance was approved for five (5) non-ambulatory and 1 bedridden resident. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of four (4) total bedrooms and two (2) bathrooms. All outdoor and indoor passageways are kept free of obstruction. 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 122.7 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors/ carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 8/14/2023. Emergency Disaster Plan was last posted on 10/4/2022. First aid kit was observed to be complete. Continued on LIC809. Continued from LIC809. Four (4) staff records were reviewed, and all staff have criminal record clearance. All three (3) resident records were reviewed and complete. LPA requested the following documents to be submitted to CCLD by 12/22/2023 . LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report Resident roster Liability Insurance No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.