Facility Evaluation Report

On 06/15/23, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Jovanne Anguluan, Administrator, and explained the purpose of today’s visit. The facility is licensed for six (6) non-ambulatory residents aged 60 and over, of which one (1) may be bedridden, with a hospice waiver for two (2). Currently, the home has (5) clients. The clients are private pay clients. None of the clients have Restricted Health Care Conditions and none are utilizing postural supports or protective devices. The facilities annual fees are current.

The facility is a single-story structure located in a residential neighborhood. It consists of the following: three (3) resident's rooms, two (2) common bathrooms, living area, dining area, kitchen, and outside covered patio area.

LPA conducted a records review of (5) client records, (6) staff records, and reviewed the facility disaster plan. The facility does not handle the clients cash resources. All client & Staff records were complete. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (5) Client Medication Administration Records and did not observe any discrepancies at the time of visit.