Facility Evaluation Report

Licensing Program Analyst (LPA) Delmundo conducted an unannounced infection control annual inspection. LPA met with staff, Aura Rubilyn 'Ruby' Bucu. LPA called and spoke with Adora Santiago, administrator. LPA informed both of them the purpose of visit. Adora authorized Ruby to be with LPA during inspection. Adora arrived after about an hour and half. LPA also met with other staff, Franc Metiam.

Facility has completed COVID-19 mitigation plan and submitted to Community Care Licensing (CCL). LPA observed screening station located by the entrance door with visitor's log, hand sanitizer and no touch temperature probe. Routine symptom screening (+/-) temperature and symptom checks are done for all staff, residents and visitors. Residents are screened for COVID-19 symptoms and temperature checked daily. Staff were observed wearing mask. Supplies of centrally stored PPEs inspected.

LPA inspected the facility inside out with Ruby. LPA randomly selected 6 residents and 2 staff rooms for inspection. LPA also inspected 3 common bathrooms, staff bathroom, dining area, kitchen, laundry room, front and side yards and backyard.

There were at least 7 days of nonperishable and 2 days of perishable foods. Fire extinguishers were observed fully charge and tags showed serviced April 7, 2021. Hot water temperature in the 1 of the bathroom sinks was tested and measured at 105.6 degrees Fahrenheit.

2. No sneeze and cough etiquette poster in the dining area and hand washing posters in 3 resident bathrooms. No 6 feet physical distancing signs.