Routine inspection·July 26, 2022

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) .Ronnie Ubungen Upon arrival, Staff Julieta Tecson (JT) took LPA body temperature, and checked LPA in the visitor log book. LPA toured the facility inside out with ADM. COVID posters were observed at entrance and in the facility. Screening station with masks, hand sanitizer, thermometer and visitor log book was observed at the entrance. Living room, kitchen, dinning room and two restrooms were inspected. Trash cans were observed with covers. Paper towels were observed with holders. Posters of washing hands were observed by the sinks in kitchen and restrooms. Cloth towels were observed in the kitchen and restrooms. Three shared resident bedrooms, and laundry area were inspected. One staff live-in room was observed 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 72 degree F, and hot water temperature was at 110 degree F in facility. Five residents and three staff were observed in facility. PPE supplies were observed sufficient. Fire extinguisher was serviced on 4/20/2022. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors were tested by ADM, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways. ADM stated all the residents and staff are fully vaccinated and done with booster. No citation were noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature.