Routine inspection·April 4, 2023

Licensing Program Analysts (LPAs) Steve Chang and Ravi Patel conducted an unannounced annual inspection visit, and met with Administrator (ADM) Leilanie Pangaliman. LPAs checked 5 resident record files (R1 - R5) and 5 staff record files (S1 - S5). 6 residents (R1 - R6) and 1 staff (S3) were interviewed. LPAs toured the facility inside out with ADM. Facility license, Administrator Certificate, Personal Rights posters were observed posted at the facility. Living room, kitchen, dinning room and two restrooms were inspected. Six single resident bedrooms, and laundry room were inspected. Two staff live-in rooms are in facility. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet, knives closet, and cleaning product closet were observed locked. Room temperature was at 68 degree F, and hot water temperature was at 110 degree F in facility. Fire extinguisher was serviced on 02/24/2023. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways. No citation were noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the report was provided to ADM.