Hollywood Care Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 09:30 AM. LPA spoke on the phone with Administrator Kyong Suk Lee who informed LPA that the facility currently has no residents. Administrator arrived to the facility at 10:58 AM. Entrance interview was conducted and the reason for the visit was explained. Beginning at 11:05 AM, the LPA, along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: BEDROOMS: There are four (4) total bedrooms in the facility. Three (3) are single occupancy rooms. Bedrooms #3 & 4 contained direct exits to the outdoors of the facility. Bedroom #1 was observed to be missing a bed and other required furniture. All other resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Direct exits were observed to be missing auditory alarms. BATHROOMS: There are two (2) bathrooms for resident use. Restrooms were observed to be equipped with nonskid surfaces and contain nonskid mats. Grab bars were observed in the bathrooms and all were properly secured. The water temperature was measured in resident bathrooms to be between 124.8 and 129.0 degrees Fahrenheit which is outside of the range required by regulation. KITCHEN/GARAGE: The LPA observed the garage to be locked and inaccessible. The garage was observed to contain the facility washer and dryer along with tools, care supplies, and household chemicals. The kitchen was observed to be clean. Kitchen appliances appeared to be in operable condition. LPA observed the facility to be missing a sufficient supply of perishable and non-perishable food. LPA observed a wall mounted fire extinguisher that was fully charged and recently serviced on 06/15/2026. Cont. on LIC 809C. COMMON AREAS: This included the living room and dining room areas. LPA observed the living room to be clean and properly furnished at the time of the visit. The living room contained a television. The dining area contained a locked cabinet that contained facility files, a complete first aid kit, and adequate seating for resident use. The entryway contained all required postings. Combination smoke and carbon monoxide detectors were tested at 11:27 AM and all were functional at the time of the visit. OUTDOOR SPACE: The backyard has patio furniture including a table and chairs for resident use but is not covered. There were no bodies of water on the premises. The entryway contained a ramp and railings that were appropriately secured. EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's emergency disaster plan. The emergency disaster plan is up to date and is adequate. The plan is reviewed/updated annually by the facility’s Administrator. During today’s visit LPA obtained a copy of the facility’s emergency disaster plan. Due to no residents being in care at the facility no citations were issued during today’s inspection. Advisory notes were issued and the Administrator was informed that prior to accepting clients into care corrections would need to be made. Exit interview conducted and report was issued.the state’s words, verbatim · CDSS document, Jun 18, 2026

The state marks this report as 7 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 09:36 AM. LPA spoke on the phone with Administrator Kyong Suk Lee who informed LPA that the facility currently has no residents. Administrator arrived to the facility at 11:23 AM. Beginning at 11:25 AM, the LPA, along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: Fire extinguisher was fully charged and recently serviced on 05/20/2025. Combination smoke and carbon monoxide detectors were tested at 12:30 PM and all were functional at the time of the visit. No fire clearance concerns were observed. KITCHEN/GARAGE: The LPA observed the garage to be locked and inaccessible. The garage was observed to contain the facility washer and dryer along with tools, care supplies, and household chemicals. The kitchen was observed to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of seven (7) days non-perishable food. No perishable food was observed. Cleaning supplies are located in a locked under-sink cabinet. Medication cabinet was observed to be locked. COMMON AREAS: This includes the living room and dining room areas. LPA observed common area to be clean and properly furnished at the time of the visit. The living room contained a television. The dining area contained a locked cabinet that contains facility files and adequate seating for resident use. The entryway contained required postings and an infection control point. Continued on LIC 809C. BATHROOMS: There are two (2) bathrooms for resident use. Restrooms were observed to be equipped with nonskid surfaces and contain nonskid mats. Grab bars were observed in the bathrooms and all were properly secured. The water temperature was measured in resident bathrooms to be between 129 and 132.8 degrees Fahrenheit. BEDROOMS: There are 4 (four) total bedrooms in the facility. Three (3) bedrooms were observed to be single occupancy rooms. Bedroom #1 was observed to be missing a bed. All other resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. OUTDOOR SPACE: The backyard has patio furniture including a table and chairs for resident use but is not covered. There were no bodies of water on the premises. The entryway ramp and exit ramps located at the back of the facility were observed to lack appropriate safety railings. EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's emergency disaster plan. The plan is reviewed/updated annually by the facility’s Administrator. Due to no residents in care no citations were issued. Although advisory notes were issued to the licensee. Exit interview conducted and report was issued.the state’s words, verbatim · CDSS document, May 22, 2025

The state marks this report as 8 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Trevor Byrne Angela Barutyan and licensing program manager (LPM) KaSandra Lopez arrived at the facility unannounced to conduct a required annual visit at 09:33AM. LPAs and LPM met with representative Yeunje Kim. LPAs and LPM then spoke on the phone with administrator Kyong Suk Lee. She advised that the facility does not currently have residents. However, they will contact CCL when they plan to operate with residents again. Beginning at 09:40AM, the LPAs and LPM, along with the representative toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: Fire extinguisher was fully charged and recently serviced on 04/2024. Combination smoke and carbon monoxide detectors were tested at 09:48AM and all were functional at the time of the visit. No fire clearance concerns were observed. KITCHEN/GARAGE: The LPAs observed the garage to lack locked storage for cleaning supplies. Kitchen was observed to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of seven (7) days non-perishable and two (2) days perishable food. Cleaning supplies are located in a locked under-sink cabinet. Medication cabinet was observed to be locked. Water temperature was observed to be 127 degrees at 09:44AM. COMMON AREAS: This includes the living room and dining room areas. LPAs and LPM observed common area to be clean and properly furnished at the time of the visit. The exit door in bedroom 4 (four) contained an alarm that was non-functional at the time of the visit. No other exit doors had installed alarms. BATHROOMS: There are 2 (two) bathrooms for resident use. Restrooms were observed to be equipped with nonskid surfaces and contain nonskid mats. Grab bars were observed in the bathrooms. The water temperature was measured in resident bathroom 2 (two) and measured 124 (one hundred and twenty four) degrees. Resident bathroom 1 (one) was observed to have a hanging recessed light with exposed wiring.Report Continued on LIC 809-C BEDROOMS: There are 4 (four) total bedrooms in the facility. Resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. OUTDOOR SPACE: The backyard has patio furniture including a table and chairs for resident use but is not covered. Passageways were obstructed behind the ADU. There were no bodies of water on the premises. The entryway ramp was observed to lack appropriate safety railings. EMERGENCY DISASTER PLANNING: During today’s visit, the LPAs reviewed the facility's emergency disaster plan. The facility had an out of date form on display in the main entryway. Due to no residents in care no citations were issued. Although advisory notes were issued to the licensee. Exit interview conducted and report was issued.the state’s words, verbatim · CDSS document, Jun 27, 2024