Facility Evaluation Report

Licensing Program Analyst (LPA) Noemi Galarza made unannounced healthy and safety case management visit to check on new relocated resident whom was relocated on 3/7/2025 from Alain Crest # 197607462 . LPA met with Abigail Despi caregiver staff and explained the purpose of the visit. Assistant Administrator Runette Catibog arrived shortly after. Administrator Osvaldo Santa Ana arrived later. A physical plant tour of the facility was completed.

Resident (R1) is in a shared room. The room has required furniture.

Medication Administration Records (MARs), medications, resident file documents were reviewed.

Sufficient staff was observed. However, caregiver staff (S1) is not associated to the facility. A civil penalty is being assessed. Assistant Administrator associated S1 during the visit.

LIC 500 Personnel Report needs to be updated.

The facility has sufficient 2-day perishable and 7-day non perishable food supplies. T

The last fire drill was conducted on 3/7/2025.

Two (2) half rails were observed in R2's bed. However, the resident is not enrolled in hospice services.

Exit interview was conducted with Administrator Osvaldo Santa Ana and a copy of the report was issued.