Facility Evaluation Report

On 03/20/2025 at 2:55 PM, Licensing Program Analysts (LPAs) P. Manalo and K.Nguyen arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Care Staff, Alvin Galang, and explained the purpose of the visit. Administrator, Rachel White, gave authorization on the phone for Care Staff to sign the report. Administrator certificate is current. The facility’s fire clearance was approved for six (6) all may be non-ambulatory and three (3) hospice waiver.

LPAs toured facility with staff 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. There are no bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. 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 110.6 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.

Carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 01/22/2025. Emergency Disaster Plan was last posted on 03/28/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 01/20/2025.

At 3:03 PM, LPA reviewed 5 residents records. At 03:28 PM, LPAs reviewed 4 staff records and all are associated to the facility. At 5:00 PM, LPA reviewed a sample of resident’s medications.