Facility Evaluation Report

On this day, January 18, 2024, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with staff, Lucky Amenaghawon and Elaine Rivera, and informed the reason for visit. LPA called and left message on Eric Umali's (administrator) voice mail.

Administrator arrived at around 12:30 p.m.

Administrator submitted the facility's Infection Control Plan which LPA received on June 30, 2022.

LPA conducted inspection with Elaine Rivera. LPA inspected the kitchen, dining area, living room, bedrooms, bathrooms, side yard and backyard. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications and storage for cleaning supplies were observed locked.

Facility has 2 in 1 smoke and carbon monoxide detector that was tested, and observed functional. Facility conducts emergency and fire drills at least every quarter, and records showed last conducted November 11. 2023 and December 13. 2023 respectively. Fire extinguisher checked, observed fully charge with tag showed serviced May 5, 2023. Hot water temperature in the bathroom was tested and measured at 111 degrees Fahrenheit.

LPA reviewed 3 staff and 4 resident records, and interviewed 2 staff and 2 residents. Medications were checked and compared with doctor's orders on file and LIC622 Centrally Stored Medication and Destruction Records. Residents' P&I were checked and compared with records.