Facility Evaluation Report

On 10/25/2023 at 12:10PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with caregiver, Gaye Basilio and explained the purpose of the visit. Licensee/ Administrator, Diosdado De Luna arrived 15 minutes later. The facility’s fire clearance was approved for 5 non-ambulatory residents and 1 bedridden resident of which 1 residents maybe under hospice care.

LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full. One week of nonperishable and 2-day of perishable food supplies were available. Medications were locked in a cabinet. Hot water temperature was measured at 120 degrees F in the hallway bathroom. LPA observed grab bars and non-skid mat in the bathroom. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. First Aid kit is complete.

LPA reviewed 3 resident and 3 staff files starting at 12:55PM. LPA reviewed a sample of resident's medications starting at 2:30PM. LPA interviewed 2 residents and 2 staff at 2:55PM.

At 12:25PM, LPA observed unlocked cleaning supplies in the hallway closet and unlocked gardening tools in the backyard. Licensee locked up the cleaning supplies and gardening tools during inspection.

At 1:25PM, LPA observed R2 and R3 does not have current needs and service plans on file.

At 1:40PM, LPA observed S1 does not have chest x-ray result on file during record review.