Routine inspection·February 8, 2024

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with administrator (ADM) Jocelyn Real. 3 staff and 5 residents were observed in facility. LPA reviewed 2 resident files and 2 staff files. LPA toured the facility inside and out with ADM. License, personal right posters, and administrator certificate were observed at entrance. LPA inspected living room, kitchen, dinning area, laundry room and garage. Medication closet, knives closet, and cleaning product closet were observed locked. There are 3 shared resident rooms at first floor for residents, and 2 restrooms for residents at first floor. There are 3 staff live-in rooms, 1 office room, and 1 restroom at the second floor in facility. Room temperature was observed at 70 degree F, and hot water temperature was observed at 110 degree F. The temperature of the refrigerator was at 40 degree F, and the temperature of the freezer was at 0 degree F. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. The facility is equipped with smoke and carbon monoxide detectors. The facility equipped with fire alarm. ADM tested the smoke and carbon monoxide and fire alarm detectors, and they were working fine. The fire extinguishers were observed on service on 12/28/2023. LPA inspected the backyard, there was no obstruction to block the walkway. The facility conducted fire and emergency drill on 1/14/2024. First aid box, flash lights and night light were observed in the facility. Deficiencies noted for today's inspection. See LIC809-D. Exit interview was conducted with ADM. This report was provided to ADM for signature.