Routine inspection·April 5, 2024

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with administrator (ADM) Ven Ignacio. LPA checked 3 resident record files and 3 staff record files. 5 residents and 3 staff were observed in the facility. LPA toured the facility inside out with ADM. Facility license, Administrator Certificate, and personal rights posters were observed posted at the facility. Living room, family room, kitchen, dinning room and two and half restrooms were inspected. Six single resident bedrooms which including 3 bedrooms with restroom inside, garage, and laundry room were inspected. Two staff live-in rooms are in facility. Non-skid mats and grab bars were observed in bathrooms. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet, cleaning product closet was observed locked. Knives closet in the kitchen was observed unlocked. ADM locked the knives closet before LPA left the facility. Room temperature was at 72 degree F, and hot water temperature was at 100 degree F in facility. ADM adjusted the water temperature to 107 degree F before LPA left the facility. The temperature of the refrigerator was at 40 degree F and the temperature of the freezer was at 0 degree F. First aid box and night lights were observed in the facility. Fire extinguisher was serviced on 04/13/2023. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors and fire alarm system were tested by ADM, and were working fine. ADM tested the sinal system and it was working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways. The last time the facility conducted the emergency drill was 11/30/2023. Citations were noted today. See LIC809-D. This report was provided to ADM for signature. A copy of the report was provided to ADM.