Love Home Care for Elderly

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA were met by Hyo Seon Kwak, Caregiver and explained the purpose of the visit. Shortly after, Administrator Eunice Kim arrived and assisted LPA with the inspection. The facility is approved to serve elderly residents, age 60 and over, (4) ambulatory and (2) non-ambulatory, non ambulatory in room #1 only. Hospice waiver approved 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 and Personal Protective Equipment (PPEs) were maintained. Bathroom has hygiene items such as hand soap and toilet paper. Operational Requirements: Fire Drill is conducted monthly and the last drill was conducted in July 2025. Facility has working signal systems in exit points. Facility maintains liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate and expires on 10/21/2026. Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood which consists of (4) resident bedrooms, (2) bathrooms, living room, dining room, kitchen, and attached garage. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, linen, light, chair and sufficient closet space. LPA observed cameras in the common areas with no audio. The fireplace is adequately screened with a lock. Backyard was inspected and has a shaded area and sitting area.There is a swimming pool in the backyard and is secured by a fence. There is (1) fire extinguisher in the facility which was purchased on 09/08/2025. Smoke alarms and carbon monoxide were tested and operable. Water temperature reading measured within the required 105 - 120 degrees Fahrenheit. Hot water readings were 111.0 deg F in bathroom #1 and 108.2 deg F in bathroom #2. ****REPORT CONTINUED ON LIC809-C***** Staffing: A total of (5) caregivers including the Administrator provide care and supervision to the residents. Staff employed are over the age of 18 and have criminal background clearance, fingerprint cleared, have the required training and associated to the facility. Personnel Records-Training: Staff files are maintained at the facility and were reviewed for criminal background clearance and training. Personnel records have health/TB screenings. Current Administrator's certificate is pending, expires on 05/15/2026. Staff have current CPR & First Aid certificates, health assessment and TB results, and on-going training. Resident Rights-Information: Resident personal rights are posted. Visiting policy is posted at a location that is visible and accessible to residents and families. Facility provides internet services to all residents and have access to the facility phone. Planned Activities: Information regarding Dementia is part of training for direct care staff and is included in the Plan of Operation. The facility provides sufficient space to accommodate both indoor and outdoor activities. Food Service: The kitchen was inspected and did not have sufficient supply of 2 day perishable & 7 day non-perishable food. Pesticides and cleaning supplies are kept away from the food preparation areas. Staff provide modified diet to (1) resident as prescribed by a physician. Incidental Medical Services: All (5) residents' medications were reviewed during the visit. The facility uses the Medication Administration Record (MAR) log to document medications given. Medications were stored in a locked cabinet and inaccessible to residents. Resident Records-Incident Reports: All (5) resident files were reviewed containing admission agreements, Physician's Report, Medical/Functional assessments, Needs and Services Plans, TB clearance, Personal rights, Medical Consent, Medication Records. Disaster Preparedness: The facility has a complete Emergency Disaster and Mass Casualty Plan containing emergency evacuation, storage and preservation of medications, operation of manual assist devices. The facility conducts emergency drill on a monthly basis. Last fire drill was conducted on October 1, 2025. Residents with SHN: (6) residents are under hospice care. Physician orders for use of half bed rails were reviewed in (3) residents files. No bedridden residents. No deficiencies cited and Technical Assistance issued. Exit interview and a copy of this report was provided to the Administrator, Eunice Kimthe state’s words, verbatim · CDSS document, Oct 27, 2025

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: Required - 1 Year

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection on 10/8/24. LPA arrived unannounced and explained the reason of the visit to licensee/administrator, Eunice Kim. The facility is licensed for 6 residents ages 60 and over. There may be (4) ambulatory and (2) non-ambulatory residents. The non-ambulatory is approved for room #1 only. There is a hospice waiver approved for 6 residents. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools to inspect the facility. The single story home consists of 4 resident bedrooms, 2 bathrooms, living room, dining room, kitchen, and attached garage. There is a swimming pool in the backyard and is secured by a fence. The fireplace is adequately screened with a lock. There are no items obstructing the walkways. There are smoke and carbon monoxide combo detectors located in each room and hallway. The bedrooms have the required furniture and storage space. There is sufficient lighting throughout the facility. Facility has sufficient food supplies of perishable and non-perishable. The hot water temperature was measured within the required range of 105-120 degrees F. There are surveillance cameras located in the common areas. Medications are centrally stored and locked in a cabinet located in the dining room. LPA reviewed medications for 2 residents and no discrepancies were found. Both residents' files were reviewed and Resident #2's physician's report was not current. LPA reviewed 3 personnel files. The administrator's certificate expires on 5/15/24 but was verified that the renewal documents were submitted. Staff have current CPR & First Aid certificates, health assessment and TB results, and on-going training. Facility has the updated LIC610E Emergency Disaster Plan with the emergency procedures posted. Licensee is conducting emergency disaster drills with staff. The facility has appropriate liability insurance covering the $1,000,000 per occurrence and $3,000,000 in annual aggregate. LPA issued a deficiency on the LIC809D form. A technical violation was given. An exit interview was held and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Oct 8, 2024

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection on 10/10/23. LPA contacted the administrator, Eunice Kim, who arrived shortly after to allow entry. There is currently no resident residing at the home. The facility is licensed for 6 residents ages 60 and over. There may be (4) ambulatory and (2) non-ambulatory residents. The non-ambulatory is approved for room #1 only. There is a hospice waiver approved for 6 residents. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools to assess the facility. The one story home consists of 4 resident bedrooms, 2 bathrooms, living room, dining room, kitchen, and attached garage. There is a swimming pool in the backyard and is secured by a fence. There are no items obstructing the walkways. There are smoke and carbon monoxide combo detectors located in each room and hallway. The bedrooms are adequately furnished and ready for move-in. The resident medications will be stored in a locked cabinet located in the dining room. The fireplace is not in use and is adequately screened with a lock. There are surveillance cameras around the common areas. Facility has non-perishable items in storage and per administrator, she will purchase perishable items when they receive their first resident. The administrator's certificate expires on 5/15/24 and has current CPR & First Aid certificate. Facility has the updated LIC610E Emergency Disaster Plan with the emergency procedures posted. The facility maintains liability insurance covering the $1,000,000 per occurrence and $3,000,000 in annual aggregate. There are no deficiencies issued today. A technical violation was given. An exit interview was held and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Oct 10, 2023

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.