Routine inspection·February 28, 2024

Licensing Program Analysts (LPAs) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Leilanie Pangaliman. LPAs reviewed 3 resident files and 3 staff files. 4 residents and 2 staff were observed in the facility. LPA 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. Non skid mats were observed in the bathrooms. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet, knives closet were observed locked. Dish cleaning product was observed unlocked in the kitchen. Room temperature was at 69 degree F, and hot water temperature was at 119 degree F in facility. The temperature of the refrigerator was at 38 degree F, and the temperature of the freezer was at 0 degree F. First aid box and flash lights were observed in the facility. Door alarms were observed in the facility. LPA tested the door alarms and the facility signal system, and they were working fine. Fire extinguisher was serviced on 02/20/2024. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Fire alarm and smoke detectors were tested by ADM, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways. The facility conducted the fire and emergency drill on 1/27/2024. ADM added a lock under the sink in the kitchen to put the dish cleaning products before LPA exited the facility. Deficiencies were noted today. See LIC809-D. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the report was provided to ADM.