Routine inspection·September 30, 2025

Licensing Program Analyst (LPA) Dang Nguyen made an unannounced visit to conduct a Required Annual Inspection. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Licensee/Administrator Zayden Chen. According to the facility’s license, the facility has a maximum capacity for six (6) residents, of whom all may be non-ambulatory and one may be bedridden. Per LPA observation and manager interview: During today’s inspection, there were a total of zero (0) residents in care. The facility’s license does not include endorsements for delayed-egress doors or secured perimeter doors, and neither of these were present. LPA, accompanied by the Licensee/Administrator, toured the interior and exterior of the facility, and inspected all common areas and bedrooms. LPA also reviewed the Licensee/Administrator’s personnel file. During the facility tour, LPA observed, and Licensee interview confirmed: -The facility did not have working telephone, as required. -The facility’s fire extinguisher had not been serviced within the last twelve (12) months, as required. [During today’s visit, Licensee phoned a professional vendor to make a service appointment for the extinguisher.] -The facility required cleaning and/or repair in these areas: a) The facility’s doorbell annunciator/speaker was partially dismantled and was not working; b) The facility’s electric garage door (which is a potential emergency exit route per the facility sketch) was not working; c) An electrical outlet in Bedroom #4 was missing a receptacle; d) Two (2) of the electrical outlets in Bedroom #2 were missing plastic covers; [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] e) A window screen in Bedroom #2 was broken; f) The sliding window screen in the Living Room was broken; g) Two (2) of the drawers in Bathroom #1 were missing pull knobs; h) Stowed inside Bedroom #6 was a non-working refrigerator/freezer combo that Licensee said was junk and needed to be discarded. -Hot water temperature at taps intendend for resident use were too hot, per regulation: Bathroom #1 Sink was 131.4 F and Bathroom #2 Sink was 139.3 F. [Regulation required these taps to be between 105 F and 120 F.] -1 of 2 bathroom showers did not have a slip-resistant mat, strip, or similar flooring, as required. -The facility had Internet service but did not have a telecommunications device at the facility which was dedicated for resident use. Pathways were free of obstruction and trip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were working. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility’s ambient internal temperature was complaint at 76 F. Appliances to preserve perishable food were also compliant in temperature. Cooking/dining equipment and utensils were present and in good condition. There was a locked area for the storage of client medication. Confidential records were stored in locked areas. The facility’s fireplace was screened, as required. The facility did not have a swimming pool or similar body of water. Per the Licensee, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detector, night lights, and emergency lighting were working. Required licensing postings were observed in visible areas of the facility. Licensee presented proof of current business liability insurance. Since the facility currently has zero (0) clients in care, no deficiencies were cited during today’s inspection. However, LPA issued six (6) Technical Violations (refer to the LIC 9102-TV pages). An exit interview was conducted with Licensee/Administrator Zayden Chen, to whom a copy of this report, the LIC9102-TV pages, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.