Facility Evaluation Report

On this day, May 27, 2026, at 1:50 pm, Licensing Program Analyst (LPA) Delmundo arrived unannounced to continue the annual required inspection that was started on May 26, 2026. LPA met with staff, Rosemarie Salas, and informed the reason for visit. Jezrael Pascual, administrator (ADM) arrived at around 2:25 pm.

LPA reviewed 5 residents and 5 staff records. LPA checked residents' medications and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. Facility does not handle residents cash resources and/or P&I. Facility conducts disaster drills and records showed last conducted November 9, 2025 and February 25, 2026. Administrator stated she'll have the disaster drill conducted tomorrow, May 28, 2026.

Administrator to submit updated/current copies of the following documents by June 10, 2026:

1. LIC308 Designation of Facility Responsibility

3. LIC610E Emergency Disaster Plan (9 pages)

-at 2:30 pm, staff (S2) has no required training for 2025, no LIC503 Health Screening

-at 3:00 pm, staff (S3) who started 02/2026 has only total 16 hours training.