Facility Evaluation Report

On 09/24/25 at 08:30AM, Licensing Program Analyst (LPA) Andrew Christy and Licensing Program Manager (LPM) Harpreet Humpal arrived unannounced to do an annual inspection. LPA and LPM meet with caregiver Gualip Hermenelinda and explained the purpose of the visit. Administrator Mary Malekamu arrived at 9:15AM. Facility currently houses four (4) residents.

LPA inspected the facility inside out. Facility is kept at a comfortable temperature at 73.0 degrees Fahrenheit. There is no body of water. Physical plant is consistent with the facility sketch received by Central Application Bureau (CAB) and approved by the fire department. LPA inspected the living room, dining area, kitchen, bedrooms, hallways, bathrooms, side and backyards. Bedrooms were observed appropriately furnished with adequate lighting and drawers. Facility has sufficient towels, extra bed sheets and comforters. Equipment and supplies for residents' personal hygiene are available and on site. Hot water measured to 119.6 degrees Fahrenheit. Food supplies checked and observed good for seven days of non-perishables. Facility was observed equipped with refrigerator, microwave, dishwasher, washer and dryer. Outdoor activity space was observed furnished with tables, chairs and shade. Fire extinguishers were observed fully charge and tags showed serviced 09/22/2025.

At 10:30AM, LPA reviewed four (4) residents records and five (5) staff records. Emergency Disaster Plan was last updated 09/22/2025.