Facility Evaluation Report

At 11:35 am on this day, September 12, 2024, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA was granted entry by staff, Lourdita Balba. LPA also met with other staff, Marieta Balilo, and informed the purpose of visit. LPA called and spoke with

Maria Theresa "Tek" Ordiniza, assistant administrator (ADM), who gave permission to Marieta Balilo to be with LPA in touring the facility. There were 3 residents present when LPA arrived. ADM arrived at around 12:20 pm.

Facility has Infection Control Plan that was submitted and received by LPA on June 30, 2022.

LPA inspected the facility inside and out including but not limited to bedrooms, bathrooms, kitchen, dining and living areas, garage, side yard and backyard. There is a supply of 7 days of non-perishable and 2 days of perishable foods. Central storage for medications was observed locked.

Fire extinguisher was observed fully charge with tag showed serviced March 19, 2024. Facility has carbon monoxide and smoke detectors that were tested and observed in operating condition. Hot water temperature in the common bathroom was tested and measured at 119.8 degrees Fahrenheit. Facility conducts disaster drills at least every quarter and records showed last conducted September 2, 2024.

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