Facility Evaluation Report

On 09/28/2025, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced annual inspection. Upon arrival LPA met with staff Christyna Blanco. Later, the Administrator Tangonan Maria joined LPA and explained the reason for the visit.

The facility has an approved fire clearance to be licensed to serve residents aged 60 and above, six (6) non-ambulatory, and (1) of which may be bedridden. Bedrooms 2 and 3 are allowed 1 non-ambulatory each. Bedroom 1 is allowed 2 non-ambulatory. Bedroom 4 is allowed 1 non-ambulatory and 1 bedridden. Hospice waiver approved for six (6). The facility is a single-story home: 4 bedrooms, 1 staff bedroom, 2 bathrooms, dining room, living room, kitchen, backyard, and an attached garage. Emergency disaster drill last conducted 09/09/2025.

During today's visit LPA Richard toured the physical plant inside and outside, reviewed the food supply, tested the smoke/carbon monoxide detectors, reviewed (4) staff files, (6) resident files, medications, and medication administration records for (6) residents. All (6) resident bedrooms contained required furniture's, lamps, dresser, chair, and closet.