Facility Evaluation Report

On this day, June 13, 2023, at 11:10 a.m., Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA was granted entry by staff, Randall Cabading. LPA spoke over the phone with Marissa Legarda, administrator, and informed the reason for visit. Administrator authorized Romark Merjilla to be with LPA during inspection. LPA also met with other staff, Nancy Da Anton. Administrator arrived at 11:46 a.m., followed by another staff, Rudy 'RJ' Golilao.

Facility submitted the Infection Control Plan on June 24, 2022.

LPA toured the facility inside out. LPA inspected the kitchen, dining area, living room, bedrooms, bathrooms, front, side and backyard. Facility has sufficient perishable and non-perishable foods. Fire extinguisher was observed fully charge with tag showed serviced August 8, 2023. Facility has 2 in 1 carbon monoxide and smoke detector that was tested and observed functional. Hot water temperature in the resident's room was tested and measured at 112.6 degrees Fahrenheit. Facility conducts fire drills monthly, and records showed last conducted May 26, 2024.

LPA reviewed 5 residents and 5 staff files, and interviewed 2 staff. Medications were checked and compared with doctor's order and LIC622 Centrally Stored Medication and Destruction Records. Residents' P&I checked and compared with last recorded balance.

-from 12:50 p.m. to 1:15 p.m., all 5 residents do not have LIC9172 Functional Capability Assessment on file. -at 2:00 p.m., R2 has Risperdal (2 mg 1 tab BID) listed on LIC602 Physician's Report but facility does not have this medication nor have discontinued order on file.