Facility Evaluation Report

On 09/04/2024 at 11:30 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Banaag Yamsun and explained the purpose of the visit. The facility’s fire clearance was approved for four (4) Non-ambulatory. Hospice waiver for two (2) residents. Administrator certificate # 6019296740 expires 07/01/2025.

LPA toured facility with Banaag including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of four (4) total bedrooms which 4 bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 76 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 bathroom was measured at 105 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. Centrally stored medication and sharps were locked and inaccessible to residents.

Smoke and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 08/22/2024. Emergency Disaster Plan was last posted on 09/04/2024. First aid kit was observed to be complete.

LPA reviewed 4 residents records. LPA reviewed 3 staff records and 2 of 3 have current first aid training and associated to the facility. LPA reviewed a sample of resident’s medications.