Routine inspection·January 26, 2024

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection, and met with House Manager (HM) Virginia Quezada . LPA reviewed 3 resident files and 3 staff files. LPA toured the facility with HM. LPA observed 5 residents (R1 - R5) and 2 staff (S1 - S2)in the facility. License, personal right posters and Administrator Certificate were observed in the facility. LPA inspected living room, family room, dinning room, kitchen. There are 2 restrooms for residents, a restroom for staff, 2 resident shared rooms, 2 resident single rooms, and 1 staff live-in room in facility. Two days perishable foods and seven nonperishable foods were observed sufficient. Room temperature was observed at 74 degree F, hot water temperature was observed at 110 degree F. The temperature of the refrigerator is 40 degree F, and the temperature of the freezer is 0 degree F. Medication cabinet, Knife closet, and cleaning products closet were observed locked. Fire extinguisher was serviced on 5/17/2023. The facility was equipped with smoke and carbon monoxide detectors. Smoke detector alarm system was tested, and was working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways. First Aid box, flash light and night lights were observed in the facility. Deficiency noted today. See LIC809-D. This report was provided to HM for signature. A copy of this report was emailed to HM.