Routine inspection·February 3, 2025

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by Administrator Yumi Yoo after explaining the purpose for the visit. LPA observed that Administrator Yumi Yoo has a valid Administrator certificate which expires on May 3, 2026. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents, of which one may be bedridden, and has a hospice waiver for six. The facility is a single-story home with four resident bedrooms, one of which is shared, two resident bathrooms, one of which is shared, a living room, a dining room, a kitchen, and an attached two car garage. LPA accompanied by the AD conducted a tour of the interior portion of the facility. On today's visit, LPA observed two residents in care and three staff present. Per AD, one resident is currently admitted to the hospital. LPA observed residents relaxing in their respective bedrooms. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall in the dining room. LPA inspected the four resident bedrooms, and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers, and a lamp. All resident beds had clean linens and blankets. LPA observed additional linens are stored in a storage cabinet located in the resident hallway. LPA inspected the two resident bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 115.8 and 116 degrees Fahrenheit. LPA observed the kitchen has a two day perishable and seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. The four burner gas stove lights unassisted. LPA observed kitchen knives are stored in a locked kitchen cabinet. LPA observed cleaning supplies are stored in a locked kitchen cabinet under the sink. A fire extinguisher is located in the dining room and in the resident hallway. Fire extinguishers were observed to be charged and up to date on service. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. CONTINUED ON LIC809-C LPA observed the facility conducted their last emergency disaster drill on December 20, 2024. The centrally stored medication is kept in a locked medicine cart stored in a locked closet by the entryway of the facility. LPA observed a First Aid kit stored in the closet and it was observed to have all the required components. LPA observed the facility has a three day emergency food and water supply which is located in a closet by the entryway of the facility. LPA observed the facility has an internet device dedicated for resident use stored in the dining room. The door leading to the attached two car garage is kept locked and inaccessible to resident in case. LPA observed the two car garage is used for storage and for laundry. LPA and AD conducted a tour of the exterior portion of the facility. LPA observed the exterior portion to be clear of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for resident use. The perimeter gates on the north side and southside of the facility are self-latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all three resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed three residents’ medication and medication records. LPA reviewed four staff files. All staff are background cleared and associated to the facility. Based on today's observations, there are no deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator Yumi Yoo and a copy of the report was provided.