Facility Evaluation Report

This is an amendment to an original LIC809 report issued on 09/19/24.

On 09/19/2024 at 12:35 PM, Licensing Program Analysts (LPAs) L. Alexander and Patricia Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Licensee/Administrator, Mary Sunderraj and explained the purpose of the visit. The facility’s fire clearance was approved for capacity of six (6) and hospice waiver for three (3). Administrator Certificate #60011363740 expired 06/28/2023. Administrator provided a copy of faxed re-certification on 05/24/2023.

LPAs toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of total 4 bedrooms which 4 bedrooms are occupied by the clients and a partitioned area bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature for clients is maintained at 74 degree Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the clients. All toilets, hand washing and bathing are safe, sanitary and in operating condition. The supply of extra hygiene supplies were available for clients. There is a minimum of one week supply of nonperishables and 2-day perishables food supply.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 11/28/2023. Emergency Disaster Drill was last posted on 03/03/2024. First aid kit was observed to be complete.