Facility Evaluation Report

Licensing Program Analyst (LPA) Delmundo conducted an unannounced annual/infection control inspection. LPA met with staff, Terrence Louie Da Anton, Nancy Da Anton and Romark Merjilla, and informed the purpose of visit. LPA called Marissa Legarda; no response. so LPA sent text message informing that LPA is at the facility to do inspection. Marissa authorized Terrence to be with LPA during inspection. Marissa arrived at 3:30 p.m.

Facility has an approved LIC808 Mitigation Plan on file.

LPA inspected the living room, dining area, kitchen, common bathroom, bedrooms, garage, side and backyard. There's adequate food supplies of perishables good for 2 days and non-perishables good for 7 days.

LPA observed screening station by the front entrance with hand sanitizer and no touch temperature probe and Visitor's Log. Visitor's temperature and symptom checks are done at entrance. Residents and staff are screened for COVID-19 symptoms and temperature checked and recorded daily. Facility keeps record of proof of vaccination of residents and staff, and antigen test kits are readily available. LPA observed trash bins with foot pedal operated lids and COVID-19 signages throughout the facility. Supplies of PPEs were checked. and observed adequate for 30 days. Four (4) staff were fit tested for N95 respirator and LPA obtained copies of test certificates. The rest of the staff are to be scheduled for testing.

Fire extinguisher checked and observed fully charge with tag showed serviced May 21, 2022. Hot water temperature in the common bathroom was tested and measured at 105,6 degrees Fahrenheit.