Facility Evaluation Report

On 07/15/2025 at 2:00 PM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct Required 1 Year Annual inspection. Upon arrival LPA met with Caregiver, Adrian Renz Manalastas and explained the purpose of the visit. Administrator was unavailable to attend but approved caregiver to sign report. The facility’s fire clearance was approved for 6 Non-Ambulatory.

LPA toured facility with caregiver including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 5 bedrooms are occupied by the residents and 1 bedroom are occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 73 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathrooms was measured at 110.3 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum 7 day 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 detectors were in operating condition during visit. Fire extinguisher was last purchased on 03/10/2024. Emergency Disaster plan last reviewed 7/15/2025. Fire Drills conducted 4/27/2025

At 2:10 PM, LPA reviewed 4 of 4 residents records. At 2:30 PM, LPA reviewed 3 staff records and 3 of 3 have first aid training and are associated to the facility. At 2:40 PM, LPA reviewed a sample of resident’s medications.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.