Hope Home Care for Elderly

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required-1 year visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. LPA was met by Hyo Seon Kwak, Caregiver and explained the purpose of today's visit. Shortly after, Eunice Kim, Administrator and John Kim, RN arrived and assisted LPA. The facility is approved for age range 60 and over, approved for capacity of (4) ambulatory and (2) non ambulatory. Facility has approved hospice waiver for (6) residents. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Infection control practices are maintained and staff are adhering to infection control requirements. The use of Infection Control procedures are reviewed/updated. Staff ensure that residents are regularly observed for physical, mental, emotional and social functioning changes. Staff ensure that appropriate assistance is provided and such changes are documented and brought to the attention of the residents' physician. Operational Requirements: The Infection Control Plan has been added to the Plan. Liability Insurance policy in the amount of $1,000,000.00 each occurrence and $3,000,000.00 in the total annual aggregate is valid, expires on 07/07/2026. Physical Plant & Environment Safety: This facility is a single story home consists of kitchen, dining room, living room, (4) resident bedrooms, (1) office, (3) bathrooms, attached garage, and a shaded patio with seating. Currently, there are (6) residents living in the home. Resident bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light and sufficient closet space. Smoke alarms and carbon monoxide were tested and operable. LPA observed a fire extinguisher near the dining area purchased on 09/08/2025. Knives, cleaning solutions, and disinfectants are locked and inaccessible to residents. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Exit doors are free of any obstruction and there are no pools or large bodies of water. Backyard was inspected and has a shaded area and sitting area. LPA observed a shed in the backyard being used as a resting area/bedroom for staff. There are surveillance cameras in the common areas.*****Refer to LIC 809C for the continuation of this report.***** Staffing: A total of five (5) staff members including the night staff and Administrator provide care and supervision to the residents. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have training and associated to the facility. Current Administrator's certificate is pending, expires on 05/15/2026. Personnel Records-Training: Staff files are maintained at the facility. LPA reviewed (5) staff files including the Administrator. Proof of staff training, health clearance, and vaccinations are current. Dementia care is part of training for direct care staff. Resident Rights-Information: Resident rights are posted. Facility provides internet service and phone to the residents. Planned Activities: The facility provides sufficient space to accommodate both indoor and outdoor activities. Food Service: There is sufficient food supplies of 2-day perishable and 7-day supplies of non-perishable items. The food is properly stored in the refrigerator. Pesticides and cleaning supplies are kept away from the food preparation areas. There is one (1) resident with special diet residing at this facility. Incidental Medical Services: The medications are centrally stored and in their original containers. The facility uses the Medication Administration Record (MAR) log to document medications given. Administrator did not indicate the time in which residents' medications were administered in a given day. Resident Records-Incident Reports: LPA reviewed (5) resident files. Residents files are maintained at the facility. Physician's Report (including TB and Ambulatory Status), Consent For Medical Treatment, Special Incident Reports, Client Personal Property and Clients Personal Rights observed. Disaster Preparedness: The facility has a complete Emergency Disaster and Mass Casualty Plan which is posted. Facility conducts emergency drill (earthquake & fire) at least quarterly. Last fire and earthquake drills were conducted on 10/01/2025. Residents with SHN: Facility accepts and retains residents with dementia. Facility has sufficient space to permit residents with dementia to wander freely and safely. Administrator ensures that there is at least one night staff person awake and on duty for night supervision of residents with dementia. LPA observed (3) residents with bed rails, however, only (2) residents have physician's authorization. One of the residents, (R5) is not receiving hospice care has full bed rail that is prohibited. Additionally, R5 does not have a physician's order on file. Deficiencies cited on LIC 809D. Exit interview, appeals rights and a copy this report was provided to Administrator, Eunice Kim.the state’s words, verbatim · CDSS document, Nov 4, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection on 11/19/24. LPA met with Staff, Hyo Kwak, and explained the reason for the visit. Administrator, Eunice Kim, arrived shortly after to assist with the visit. The facility is licensed for 6 residents ages 60 and over, of which 2 may be non-ambulatory. There is a hospice waiver approved for 6 residents. LPA toured the facility and observed the following: The facility is a single family home consisting of 4 resident bedrooms, 1 staff office behind bedroom #1, 3 bathrooms, living room, dining area, kitchen, and attached garage. The backyard has an area for gardening and relaxation. There is swimming pool on the premises. There are an operable carbon monoxide detector and smoke detectors throughout the facility. The hot water temperature was measured within the required range of 105-120 degrees F. The fireplace is secured by a locked gate. There is sufficient space for indoor and outdoor activities. Staff are cleaning and disinfecting the facility at least once a day. The facility has surveillance cameras in the common areas. Facility has sufficient food supplies, 2 day perishable and at least a week of non-perishable items. Lunch and dinner are catered from a local food vendor. Facility accepts and retains residents with dementia. Staff are ensuring that incontinence residents are changed often and the facility remains free of odor from incontinence. LPA reviewed the 4 Staff and 5 residents files today. Staff files are complete and have current CPR & First Aid certificates. They also have the sufficient number of hours for dementia care training. All the resident files have the admission agreement, medical assessment with TB results, consent forms, property valuable form, and Appraisal/Needs and Services Plan. Medications are centrally stored and inaccessible to residents. LPA reviewed all 5 residents' medications and they are being given as prescribed by the physician. Information for appropriate reporting agencies are posted at the facility. Residents' rights are respected and implemented by staff. The Emergency Disaster Plan is posted with contact numbers and at least 2 relocation sites. No deficiencies were issued today. However, technical assistance were given. An exit interview was held and a copy of this report along with appeal rights are given to the administrator.the state’s words, verbatim · CDSS document, Nov 19, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection. LPA arrived unannounced and met with Licensee Eunice Kim and explained the purpose of the visit. The facility is licensed for a capacity of 6 residents, ages 60 and over, of which 2 may be non-ambulatory. There is an approved hospice waiver for 6 residents. LPA conducted the inspection using the Compliance and Regulatory Enforcement (CARE) Tools. The following were observed: Infection Control: Facility staff are using appropriate hand hygiene and wearing gloves while assisting residents when necessary. Staff continue to clean and disinfect daily and more often for high touched surfaces. Facility had submitted the Infection Control Plan. Operational Requirements: The facility accepts or retains residents with dementia. There are currently 4 residents diagnosed with dementia residing at the facility. 2 out of the 6 residents are non-ambulatory. Licensee has the sufficient amount for liability insurance that is required. Physical Plant & Environment Safety: The facility consists of a single story building with 4 resident bedrooms, 3 bathrooms, living room, dining space, kitchen, and attached garage. The backyard has area for gardening and relaxing. There are no swimming pool or bodies of water on the premises. There are no firearms or weapons stored at the facility. There are 2 operable carbon monoxide detectors and smoke detectors throughout the facility. The hot water temperature was measured within the required range of 105-120 degrees F. The fireplace is secured by a locked gate. Planned Activities: Facility has sufficient space to accommodate indoor and outdoor activities. There are sufficient supplies and equipment to meet resident's physical capability. Food Service: There are sufficient food supplies of 2-day perishable and a week of non-perishable items. The food are properly stored in the refrigerator. The facility purchases meal plans from a food vendor for lunch and dinner. Staffing: The facility has sufficient staffing to meet the needs of the residents. Per administrator, there are backup staffing if needed. Personnel Records-Training: LPA reviewed 4 Staff files. The administrator's certificate expires on 5/15/24. Staff have fingerprint clearance and associated to the facility. All staff have current CPR and First Aid certificates. Licensee provides on-going training to staff. Resident Records-Incident Reports: LPA reviewed 6 resident files. The files contain the admission agreement, medical assessment with TB results, consent forms, property valuable form, and Appraisal/Needs and Services Plan. The physician's report for resident #6 with dementia is not current. Resident Rights-Information: Information for appropriate reporting agencies are posted at the facility. Residents' rights are respected and implemented by staff. Disaster Preparedness: The facility has an Emergency Disaster Plan posted with contact numbers and at least 2 relocation sites. Incidental Medical & Dental: The medications are centrally stored. LPA reviewed 6 residents' medications and they are being given as prescribed by the physician's orders. Staff assist and transport residents to their doctor, dental, and specialist appointments. Residents with SHN: Facility accepts and retains residents with dementia. Staff are ensuring that incontinence residents are changed often and the facility remains free of odor from incontinence. A deficiency is issued on the LIC809D. Technical assistance are provided as well. An exit interview was held. A copy of this report along with appeal rights are given to the licensee.the state’s words, verbatim · CDSS document, Nov 13, 2023

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Cynthia Chan conducted a case management visit to interview staff. LPA met with Staff, Peter Kim, and explained the purpose for the visit. LPA obtained a copy of the personnel record and interviewed Staff #1 who was on duty. No deficiency was issued. A copy of this report was given to the staff.the state’s words, verbatim · CDSS document, Oct 10, 2023