Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez made unannounced healthy and safety case management visit to check on 2 new relocated residents who were relocated on 3/05/2025 and 03/06/2025 from Jennae Crest - 197607853. LPA met with Maria Isabel Tangonan, Administrator and explained the purpose of the visit. A physical plant tour of the facility was completed.

· Resident (R1) is in a shared room, R2 is in private room. The rooms have required furniture.

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

· Sufficient staff was observed and providing care.

· No slip mat was observed in one restroom.

· LIC 500 Personnel Report needs to be updated.

· The facility has sufficient 2-day perishable and 7-day nonperishable food supplies.

· The last fire drill was conducted on 01/05/2025.

· Full rails were observed in R1's bed. However, resident has required doctor’s orders. Full rails were observed for R2, However, the resident is enrolled in hospice services.

· Smoke Alarms were tested and operational.

Exit interview was conducted with Administrator Maria Isabel Tangonan and a copy of the report was issued. Appeal rights provided