Facility Evaluation Report

On 08/13/2025 at 9:30 AM, Licensing Program Analysts (LPAs) P. Manalo and K. Nguyen arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Administrator, Romulo Bautista, and explained the purpose of the visit. Administrator certificate is current.

LPAs toured facility inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms which 4 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. LPAs observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 114.4 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents.

Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 08/15/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 06/10/2025.

At 10:30 AM, LPA reviewed 6 residents records. At 11:00 AM, LPA reviewed 4 staff records and 4 of 4 have current first aid training and associated with the facility. LPA reviewed two samples of residents’ medications.

Exit interview conducted with Administrator and a copy of this report provided.