Routine inspection·April 6, 2026

Licensing Program Analyst (LPA) Vaid conducted an unannounced annual inspection visit. LPA met with facility administrator, Hardie Lin. The purpose of today's visit was discussed. The facility has a capacity of 120 residents. The facility is licensed to serve elderly residents aged 60 and above, approved for 120 non-ambulatory residents of which 21 may be bedridden. The facility has five (5) Hospice Waiver on file. Annual licensing fees are current. Today’s census is 103. LPA Vaid utilized the Compliance and Regulatory Enforcement (CARE) tools for today’s visit. 1. Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were observed. The facility has an Infection Control Plan, Updated 01/15/2026. 2. Operational Requirement: Liability Insurance is updated and in the amount of at least ($1,000,000) peroccurrence and ($3,000,000) in total annual aggregate is in place, expires 12/30/2026. 3. Physical Plant and Environmental Safety: The facility is located in a commercial area. It is a two-story building with 60 resident rooms. Facility consists of lobby/reception area, office, medication room, activity room, TV/entertainment room, beauty parlor, employee break room with lockers and time clock, laundry room, kitchen, and dining room. Residents' medications are centrally stored and locked in the medication room, inaccessible to residents in care. LPA Vaid inspected ten (10) residents’ rooms. Resident bedrooms have the following furniture; bed, chair, dresser, lighting fixture and personal storage space as required. Mattress pads were observed on all beds. Bathrooms inspected were clean, operable, and furnished with the required grab bars and skid proof materials in the shower. Hot water temperature was in a range of 106.8-117.6 degrees Fahrenheit which is within Title 22 Regulation guidelines. (Continue on 809C) All the cleaning supplies and chemicals are stored and locked in a cabinet in the laundry room area. Linen and towels are stored in housekeeping closets. Extra personal hygiene products are stored in the locked closet upstairs. The carbon monoxide detectors were inspected, and they are working properly. The facility has tables and chairs for residents to utilize outdoor activity. The Passageway, walkway and patio are free of obstruction. 4. Staffing: The facility has sufficient staff, and the night supervision staff have current CPR/first aid certification. 5. Personnel Record-Training: All the staff files are maintained in the facility. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. All the direct care staff have ongoing Medication Management and other required Training. However, training certificates are current. 6. Resident Records-Incident Reports: Resident files are maintained at the facility and have the following documents in their files - Admission agreements, Identification & emergency information, pre-admission appraisal/appraisal needs & services plan. 7. Resident Rights-Information: The Complaint, Ombudsman and CCLD poster and residents’ personal rights are posted by the main entry and upstairs next to elevators. Visiting hours are included in admission agreement. 8. Planned Activities : Facility has sufficient space to accommodate indoor and outdoor activities. There are sufficient supplies and equipment to meet resident's physical capability. 9. Food Service: The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be very clean and sanitary. The food is properly stored in the refrigerator (clean, labeled and well maintained). Special diets and mechanical diets are prepared daily. Pesticides and cleaning supplies are kept away from the food preparation areas. Kitchen is kept clean and free from rodents. 10. Incidental Medical and Dental: The medication is centrally stored and locked in the medication room behind the reception office. Seven (7)) centrally stored resident medications were reviewed, which contained 30-day supply of medications. 11. Disaster preparedness : Fire drills are conducted every quarter. 11/22/25, last drill conducted. The facility has an Emergency Disaster Plan (LIC610E). The facility has three alternative temporary shelter locations. 12. Resident with Special Health Needs: No resident is currently on postural support. Individual Service Plans and Appraisals are on file. No deficiencies were observed during today’s visit. An exit interview was held. A copy of this report was provided to the administrator.