Routine inspection·November 7, 2022

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into the facility by Administrator Haeryun Cho and explained the reason for the visit. Administrator Haeryun Cho has an administrator certificate expiring on 06/14/2023. At 10:02 AM, LPA toured the facility with Administrator Cho. Facility is two stories with licensee living quarters on the second floor. Facility has six residents in care during today's visit, with no residents on hospice care. LPA observed residents relaxing in the facility. All residents appeared happy and well taken care of. Facility appears clean and sanitary. All resident's rooms had required elements as well as restrooms stocked with soap/ sanitizer. LPA observed the screening/ sanitizing station in the entrance of the facility. Facility takes resident and staff temperatures daily but does not document. Facility has covid precaution postings as well as required department postings. LPA toured the kitchen and observed ample food supply. Kitchen appliances are operational. LPA observed medications and toxins are secured during today's visit. Facility has completed the mitigation plan and plan has been approved. LPA observed emergency food and water as well as the first aid kit which contained all required items. Fire extinguisher is mounted and charged. Smoke detectors tested operational. LPA toured the outside grounds and observed the outside visitation area. Exit gate is unlocked and self latching. Residents participate in activities such as exercise and bible study. Facility has ample supply of PPE and cleaning supplies. All staff and residents are vaccinated for Covid-19. LPA reviewed select resident files and all files were up to date including updated emergency information and physician reports. LPA consulted with Administrator regarding the importance of hand washing signs in facility restrooms as well as reviewing all physician reports for accuracy. No deficiencies noted during today's visit. Exit interview conducted and a copy of this report was left at the facility.