Routine inspection·August 27, 2024

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met with Administrator, Jung Hyun Kim, who assisted with the visit. The facility is licensed to serve six (6) residents of which three (3) may be non-ambulatory, ages 60 and above. No bedridden allowed. Hospice waiver approved for two (2) residents. During the visit, CARE tool was used, a tour of the facility was conducted, food supply/medication / staff/ residents records were reviewed, and staff/residents were interviewed. The facility was located in a residential neighborhood. The facility consisted of four (4) bedrooms (including 2 shared bedrooms and 2 private bedrooms), two (2) bathrooms, kitchen, dining room, laundry room, garage, and living room with a TV. All the rooms were furnished with appropriate furniture for residents’ comfort. The bathrooms were furnished with grab bars and nonskid surfaces. Common areas were observed for the ability to safely serve the needs of the residents. Hot water temperature was 107.4 degrees Fahrenheit. Adequate linen and personal hygiene supplies were observed. No pools and bodies of water on the premises. Facility maintained a comfortable temperature of 75 degree F for residents. Sufficient supplies of perishable and nonperishable foods were observed. Knives, tools, sharp items were inaccessible to residents. Smoke detectors and carbon monoxide detectors were operable. Fire extinguishers were fully charged. Medication, residents’/ staff’s records were centrally stored in a locked cabinet and inaccessible to residents. Toxic substances were inaccessible to residents. No deficiencies were observed and cited per California Code of Regulations, Title 22. An exit interview was conducted. This report was discussed and provided to Administrator.