Facility Evaluation Report

On this day, July 7, 2023 at 11:25 a.m, Licensing Program Analysts (LPAs) A. Delmundo and L. Fontanilla arrived unannounced to conduct an annual required inspection. LPA met with staff Maria Manjarez and Blesilda 'Blesie' Yamat, and informed the reason for visit. LPAs also met with Mauricio David. LPA Delmundo spoke over the phone with Ferdinand Ferdie' Gutierrez, administrator, who can not come to the facility, and gave permission to have Maria Manjarez to sign and receive this report.

Facility has not submitted an LIC9282 Infection Control Plan.

LPAs inspected the facility inside and out with Mauricio David and Maria Manjarez including but not limited to common areas, bedrooms, bathrooms, living room, kitchen, dining area, front, side and backyard. Facility has sufficient perishable and non-perishable foods. Fire extinguishers were observed fully charge with tags showed serviced March 15, 2023. Facility has smoke and carbon monoxide detectors that were tested and observed functional. Hot water temperature in one of the bathrooms was tested and measured at 107.6 degrees Fahrenheit.

LPAs reviewed 5 residents and 5 staff files, and interviewed 3 staff and 2 residents. Facility does not handle residents' cash resources.

-at 11:45 am, faciliy's Theft and Loss policy not posted and no Complaint poster.

-at 11:59 am, broken window blinds and protruding cable wires in room # 2.

-at 12:01 and 12:19 pm. no paper towel in dispensers in 2 bathrooms. According to staff, supply of paper towel for the type of dispensers ran out