Routine inspection·October 25, 2023

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with House Manager (HM) Michael Vu. LPA checked 5 resident files and 3 staff files. LPA toured the facility with HM. License, Administrator Certificate and Personal right posters were observed in the facility. There are 2 staff live-in rooms, 5 resident rooms, and 3 restrooms in the facility. Grabbing bars and Non skid pads were observed in the bathrooms. 3 staff and 5 residents were observed in the facility. LPA toured the kitchen, dining room, family room, laundry room and living room. The screens of windows in 3 bedrooms were observed not in good repair. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. The room temperature was 70 degree F, and the hot water temperature was 108 degree F. The temperature of the refrigerator was measured at 40 degree F, and the temperature of freezer was measured at 0 degree F. Medication cabinet was observed locked. Knives cabinet was observed locked. Cleaning chemical products cabinet under the sink were observed unlocked. Fire extinguisher was serviced on 05/18/2023. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by HM, and were working fine. First aid box, flash light for emergency, audio door alarm for the main entrance and night light were observed in the facility. LPA toured backyard with HM. No obstacles were observed blocked the walkway in the backyard. Some stuff were stocked at the backyard, HM stated the facility is going to clean it up. One storage room was observed at the backyard. A swimming pool was observed locked at the back yard. The facility had emergency and fire drill on 10/01/2023. Deficiencies were noted today. See LIC809-D. Exit interview was conducted with HM. The report was provided to HM for signature. A copy of the report was provided to HM.