Routine inspection·March 10, 2022

Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facilty in order to conduct a required annual inspection. LPA arrived at facility, was greeted and granted entry by caregiving staff after explaining the purpose of the visit. Staff called Licensee Joon Kim and Administrator Jane Kim who arrived later. At approximately 9:45am, LPA accompanied by licensee Joon Kim began the tour of the facility. There are currently fifty six (56) residents in care. Some residents are observed relaxing in their bedrooms or in the common areas and appears well taken care of. Facility appears to be clean, sanitary and free of odors in all areas inspected. LPA observed a sample of occupied and unoccupied bedrooms, each of which is observed to have all required components. Bathrooms observed are equipped with grab bars and slip mats. LPA observed a check-in station next to the entrance of the facility where temperature checks are being documented for visitors and staff. LPA observed the facility has COVID-19 Precautions posters, all required department postings and hand washing signs posted throughout. The facility has completed and submitted their LIC808 Mitigation Plan on 05/28/2021. LPA observed a sufficient supply of food and water. A 15-day supply of medication is stored and locked. Facility has an adequate supply of PPE. LPA toured the outside of the facility. Clutter and two power tools are observed to be stored outside between the kitchen and a shed after having been used recently. Items were cleared during visit. There is a water fountain on the premises with no observed standing water. Based on the observations made during today’s visit, a deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with facility representative and a copy of this report and appeals right were provided and left at facility.