Facility Evaluation Report

On 01/16/2025, at 10:25 AM, Licensing Program Analysts (LPAs) P. Manalo and L. Fontanilla arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Care Staff, Elizabeth Alba, who phoned the Administrator and explained the purpose of the visit. Administrator gave authorization for staff to sign the report.

LPAs toured facility inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 5 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents.

Smoke detectors were in operating condition during visit. First aid kit was observed to be complete.

At 10:40 AM, LPAs reviewed 3 staff records and are associated to the facility. At 10:55 AM, LPAs reviewed 5 residents records.

Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 01/23/2025:

LIC 308 Designation of Administrative Responsibility