Broadmoor Assisted Living

Type of visit: Required - 1 Year

On 08/04/2026 at 10:00AM, Licensing Program Analyst (LPA) Renese Howell-Small arrived unannounced to conduct the required annual visit to the facility. LPA met with Administrator, Grace Yang and introduced self and stated the purpose of the visit. LPA was informed that there are currently two (2) residents in care. The facility has five (5) resident bedrooms, three (3) resident bathrooms, living room, dining area and kitchen. There was an attached two car garage in the front of the house and storage unit in the backyard. LPA completed a walk through of the facility, review of records and medication(s) audit. Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 74 degrees Fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and sufficient lighting. LPA inspected resident bathrooms; bathrooms were clean and appliances were found functional. Water temperatures tested at 119 degrees Fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarm, charged fire extinguishers and first aid kit and first aid bood. Postings: Posters such as; the personal rights, emergency disaster plan, CCLD complaint poster and ombudsman were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept locked and inaccessible to residents. Resident and staff files are stored securely in the office area.. Medications were observed to be locked and inaccessible to residents. There is no swimming pool, firearms or ammunition in the facility. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for residents in care. Dishes, cups, and utensils were also stored properly. Yards/Outside: One shaded patio, one side gate with self-latching handle on the right side of the house that leads into the backyard. Record Review: LPA reviewed staff and administrator files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. LPA reviewed resident files for admission agreements, updated physician reports, and needs and services plans. LPA observed files to be complete. A technical assistance was provided during this visit. An exit interview was conducted where this report LIC809, LIC809C and LIC9102TA were discussed and copies were provided to Administrator, Grace Yang.the state’s words, verbatim · CDSS document, Aug 4, 2026

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Prelicensing

On 05/30/2025 at 9:13AM Licensing Program Analyst (LPA) Renese Howell-Small conducted an announced visit to the facility for the purpose of a Pre-Licensing evaluation. I met with Administrator, Zengqun Yang. An initial application to operate an Residential Care Facility for the Elderly (RCFE) was submitted to the Central Applications Bureau (CAB) on 07/06/2024 for a total capacity of six (6) non-ambulatory residents and one (1) bedridden. Fire clearance was granted on 03/18/2025. LPA observed the following: Structure: Facility is a house with five (5) resident bedrooms, three (3) resident bathrooms, living room, dining area and kitchen. There was an attached two car garage in the front of the house. Heating /Cooling System: Central heating and air conditioning system installed with a three split control panel located in three areas of the facility. Bedrooms: Bedroom #2 can be used for bedridden only per fire clearance. All bedrooms including the master bedroom and bedroom #2 will accommodate a bedridden resident and are adequately furnished with bed, chair, closet, appropriate linens and adequate lighting. Night lights were observed in the facility and will be placed in the hallways leading to residents' shared bathrooms. Bathrooms: All three (3) bathrooms have working toilets, wash basin, and shower with an adequate supply of paper towels, toilet paper, and soap. The water temperature was measured at 115 degrees Fahrenheit. Kitchen: The kitchen has adequate supply of dishes, glasses, utensils, pots and pans were observed. Knives/sharp instruments were secured in a locked drawer located in the kitchen There was adequate room for food storage. LPA observed the stove to be operational. Refrigerator(s)/freezer(s) were in working condition. Kitchen: There was sufficient storage for perishable food. There was adequate seating for meals for all clients. Laundry: Laundry room with washer and dryer was located in the garage. Laundry detergents and cleaning supplies were observed in the garage; which can be locked from the interior and exterior door. Living /Family Room: There was a living/family room with a TV and adequate seating for all clients. Linens and Hygiene: An adequate supply of linens was stored in a cabinet in the main hallway of the residence. . Yards/Outdoors: There is sufficient covered seating area the backyard. The gate on the right side is the exit and is self-latching. There is a storage/staff unit in the backyard. All outdoor pathways were free of obstructions. Emergency Phone Numbers and Exit Plan: Facility sketches were observed posted in the main living room area. There was (1) fire extinguisher and two (2) carbon monoxide detectors and nine (9) smoke detectors which are working and in good condition. General items: Client records will be stored in a locked cabinet in the kitchen area. First Aid kit with required components are located in the dining room cabinet. Medication will be locked in a cabinet in the kitchen area. LPA observed a facility phone and it was verified to be operational. Emergency water supply and food were observed. An exit interview was conducted, no deficiencies were cited, Component III was completed during this visit, and a copy of this report was reviewed and provided to Zengqun Yang. The facility has met the requirements according to Title 22 regulations and is ready for licensure.the state’s words, verbatim · CDSS document, May 30, 2025

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.