Routine inspection·August 9, 2021

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced Annual Required / Infection Control Visit to the above facility. LPA was met by Ok Hee Kim , Administrator and the purpose of today’s visit was explained. There are currently (3) residents in the facility . The facility consists of : 4 resident bedrooms, 4 bathrooms (1 bathroom is for visitor use), kitchen, family hall with a prayer room and recreation area, dining room, laundry room located inside the kitchen area. Physical plant inside and outside is in good repair. LPA and Administrator Ok Hee Kim toured the entire facility inside and out. Documents are posted as mandated. Resident bedrooms contain the mandated furniture. The bathrooms are clean and operational. First aid kit is fully stocked with manual, smoke detectors and carbon monoxide detector were in compliance and operational. No firearms are stored at facility and no bodies of water present. Medications are stored, locked and inaccessible to residents in administrators office. Medications and files are current and kept in administrator's office. Food supply was adequate for 2-day perishable and 7-day non-perishable. Hot water temperature is 115 degrees Fahrenheit, linens and personal hygiene supplies are adequate, hazardous toxins and/or sharp items are inaccessible to clients, Exit, walkways and/or passageways, are free of debris and/or hazards. The facility is in good repair. During the visit, LPA observed the facility infection control practices. LPA observed a sanitizing station at the facility entry, visitors are logged and temperature checked, sanitizer/soap located throughout the facility and additional sanitation supplies are stored in the facility. LPA observed staff and residents wearing masks and keeping 6 ft distance from one another. Client private rooms will be converted to isolation rooms (if needed) and required postings placed throughout the facility. The clients temperature's are checked and logged once a day. PPE's are enough for 30 days. According to the California Code of Regulations, LPA did not observe any deficiencies, therefore no citations were issued at this time. An exit interview conducted with Administrator Ok Hee Kim , Administrator and copy of report provided.