Routine inspection·November 24, 2021

Licensing Program Analyst (LPA) Spencer conducted an unannounced annual inspection focusing on the Infection Control Domain. LPA Spencer met with administrator Jung Hyun Kim and discussed the purpose of today's visit. This single-story home contains four (4) bedrooms, three (3) bathrooms, a living room, kitchen, dining area, office, backyard, and attached garage. The following was observed/inspected: The facility had a universal entrance screening area; sign-in and temperature logs were maintained. COVID-19 signage was placed in several areas of the facility, except for the front entrance. There was a sufficient supply of 2-day perishables and 7-day supply of non-perishable foods. All areas were found to be clean and in good repair. Cleaning solutions and sharps were locked. Each room contained required furniture including bed, dresser, night stand, lamp, chair, and closet. All beds contained the required linens including mattress cover, fitted sheet, flat sheet, blanket, and comforter. Bathrooms contained supplies including liquid soap and toilet paper. Administrator placed paper towels in each bathroom prior to the end of visit. Facility did not maintain a 30-day supply of PPE to include masks, gowns, and face shields. Medications were locked, centrally stored, and given as prescribed. Staff wore face masks consistently throughout the shift and group activities were spaced to encourage physical distancing. Smoke detectors/carbon monoxide detectors were present and operable. A fire extinguisher was observed to be fully charged and purchased in July 2021. Client files were inspected and emergency contact information and physician's reports were up-to-date. All staff files were inspected and contained required health screenings, criminal record clearances, and first-aid/training certificates. Administrator certificate expired on 5/15/2020; however, administrator provided proof that renewal was already submitted and is awaiting certificate in the mail. Technical advisories were issued on separate LIC9102. There were no deficiencies cited. An exit interview was conducted and a copy of this report and Appeal Rights were provided to the administrator.