Routine inspection·August 23, 2021

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced Annual Inspection, and Met with administrator (ADM) Dieu-Qui Nguyen. Upon arrival at facility, ADM took LPA's body temperature, asked LPA the infection prevention/control questionnaires, and checked LPA in the visitor log book. LPA toured the facility with ADM. LPA observed the COVID-19 posters in the facility. LPA observed the hand sanitizers at many places in facility. There are 6 bedrooms and 3 bathrooms in the facility including one resident shared room, 2 empty bedrooms and 3 staff rooms. LPA checked the kitchen, bathrooms, bedrooms, dining room, and living room. Not all the trash cans were with covers, not all the paper towels were with holders. ADM stated ADM will fix these issues within two days. LPA observed 2 residents (R1, R2) in the facility. LPA observed two staff (S1, S2) in the facility. LPA inspected the food supplies. The 2 day perishable foods and 7 day nonperishable foods are sufficient. LPA observed the medication cabinet was locked. LPA observed the PPE supplies were sufficient. LPA observed the room temperature was set to 72 degree F. LPA discussed and reviewed LIC808 with ADM. ADM stated all the staff and residents are fully vaccinated. No citation were issued during today's inspection. Exit interview conducted with ADM. This report was provided to ADM to review and to sign. A copy of this report was emailed to ADM.