Facility Evaluation Report

On 9/13/2023 at 3:15 PM, Licensing Program Analysts (LPAs) L. Alexander and L. Hall, conducted an unannounced 1-Year Required inspection. LPAs met with Banaag Yamsuan, Administrator , and explained the purpose of the visit. The Administrator holds a certificate #6053359740 which expires on 11/11/2023. The facility’s fire clearance is approved for four (4) non-ambulatory residents.

LPAs toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of four (4) bedrooms and two (2) bathrooms. No bodies of water was observed. A comfortable temperature is maintained at 76 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 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 08/18/2023. Emergency Disaster Plan was last posted on 01/23/2023. First aid kit was observed to be complete. Fire drill was last conducted on 04/11/2023.