Routine inspection·August 1, 2023

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit and met with Administrator (ADM) Ronnie Ubungen. LPA toured the facility inside out with ADM. Licensee, Personal Rights posters and Administrator Certificate were observed at the main entrance. Living room, dining room, kitchen, 3 shared resident bedrooms, 1 staff room, 2 restrooms, and laundry room were inspected. 3 staff and 5 residents were observed in the facility. Two day perishable food supplies and Seven day nonperishable food supplies were observed sufficient. Room temperature was observed at 72 degree F. Hot water temperature was observed at 118 degree F. Refrigerator temperature was observed at 45 degree F. Freezer temperature was observed at 0 degree F. all the bedrooms were observed with window screens. Fire extinguisher was serviced on 04/02/2023. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were working fine. Medications closet was observed locked. Knives closet and detergent closet were observed locked. Restrooms were observed with nonskid pad. Cloth towels were observed in the restrooms and kitchen. ADM removed the cloth towels immediately. Night lights were observed at the hallway. Staff files and residents were observed not completed. ADM agreed to update the documents to make the files completed. Exit interview was conducted with ADM. LIC809-D and Appeal Rights were attached. The report was provided to ADM for signature. A copy of the report was provided to ADM.