Pre-licensing visit·February 11, 2025

Licensing Program Analyst (LPA) Christian Gutierrez conducted a pre-licensing visit. LPA met with Jeong Moon and Tammie Cha. An application was submitted to CCLD for a Change of Ownership for a Residential Care Facility for the Elderly (RCFE) to serve 142 non- ambulatory residents age range 60 and over. The fire clearance has been approved for 138 non-ambulatory and four (4) bedridden only on the first floor. The physical plant was toured with the applicant. Component III was conducted. The facility is a four-story building located in Los Angeles, California. It is licensed for a capacity of one-hundred and forty-two (142) non-ambulatory residents, of which four (4) residents may be bedridden, facility has a hospice waiver approved for eight (8) residents. The facility consists of: (4) floors, a memory care unit on the (2) floor and medication room (1st floor). Main laundry is the basement and there is also a laundry room located on 2nd floor. Medication room, kitchen, administration office, dining room, and library were located at the first floor. LPA conducted a tour with Tammie Cha and observed the following: Each resident bedroom has the required furniture and bedding. There is extra clean linen and towels in basement laundry room. Smoke detectors/carbon monoxide detectors were observed in each room and throughout the facility and are properly operating. The facility has several fully charged fire extinguishers throughout the facility. Cleaning supplies and toxic substances were observed inaccessible to residents. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed in the kitchen. There are no firearms or weapons stored at the facility. Bathroom’s grab bars were installed properly, with skid mats in the shower area. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents. Passageways and exits are free of obstruction. SEE 809C Five (5) staff files were reviewed and included Criminal clearance record, CPR/training, and health screening with TB. Five (5) residents files were reviewed and included physicians report, TB clearance, and apparel needs and service. Last fire/earthquake drill was conducted in January of 2025. Infectious control plan was reviewed. Resident’s medications were reviewed, and no discrepancies were found. Medications are centrally stored and locked MAR log is used. No deficiency was observed during today’s visit. Exit interview was conducted with Jeong Moon and a copy of report was provided.