Facility Evaluation Report

Licensing Program Analysts (LPAs) Tao and Calderon conducted an unannounced case management visit. LPAs met with Administrator, Virgilio Agas, and Assistant Administrator, Justin Lee, who both assisted with the visit. The purpose of the visit was to check on the Health and Safety of the Residents and facility. The purpose was discussed with Virgilio and Justin.

On today’s visit LPAs conducted a health and safety check. LPAs toured the physical plant of the facility and staff file reviews. LPAs obtained a copy of the Staff roster, Resident roster, Pest control service report, electrician report of the generator, and emergency plan during the visit.

During the visit, LPAs observed the following:

1) Front entrance door – door latch is broken and not securely installed on the door.

2) Exterior wall of the facility – spider webs and dirt buildup are observed.

3) Med Room – a medication cabinet is broken and cabinet is unable securely set in place.

4) TV room (Room #102)- Screen doors are ripped and has holes. Flooring has loose pieces at the entrance which can be slide back and forth.

5) Hallway flooring is peeling near resident room #112, dining room, and emergency food storage.

6) Resident room’s window screens have holes or ripped in resident room #104, #113, #211, #235, #236, #246, #238, #300, #331, #333, and #334.

7) Resident room #119 (room in use) – Resident room’s screen door’s screens have holes and ripped.

8) Resident room #115 (room in use) – The light bulb at the back courtyard is missing. ( -continued in LIC 809C-)