Facility Evaluation Report

On 8/26/2025 , Licensing Program Analyst (LPA) M. Medina made an unannounced Annual Required inspection. LPA Medina was allowed entrance by direct care staff. License/Administrator, Fe Tungpalan was also present and conducted facility inspection with LPA.

Currently, there are four (4) residents in care. Residents observed to be relaxing in their bedrooms at time of inspection. . Facility observed to be clean, odor free, and a comfortable temperature. Facility tour began in resident bedrooms. Bedrooms observed to have all required accommodations. All areas of the facility have sufficient lighting. Residents bathrooms observed to be clean and in good repair. Bath/tub area have skid-resistant mats and grab bars. Hot water measured in bathroom and observed to be 105 degrees F. Dining room and living room have adequate seating and lighting for all residents in care. Tour of kitchen conducted. LPA observed a 2-day supply of perishable food and a 7-day supply of non-perishable food available for residents. LPA observed leftovers stored in the refrigerator and/or freezer to be properly stored and labeled. Medications observed to be locked in cabinet in hallway. Medication observed to have original labels and be administered as prescribed.

Smoke detector and Carbon monoxide detector present and visible in hallway near resident bedrooms and observed operational. Fire extinguisher has a service date of 08/15/25. All cleaning supplies observed to be locked under kitchen sink. Staff files reviewed.

LPA received a copy of updated Liability Insurance and Control of Property during visit.

Outside areas toured. All exits open freely and observed to be free of obstruction. No hazards observed.

No deficiencies cited during visit. Exit interview conduced and a copy of report provided for facility records.