Facility Evaluation Report

Licensing Program Analyst (LPA) Evelin Rios arrived to this facility to conducted an Annual Required Inspection visit. When LPA arrived she was greeted by the house manager, Dulce Villeros. Staff contacted the Administrator, Jojo Cajayon and informed him LPA was at the facility. LPA explained the purpose of the visit. Administrator was not able to meet LPA at the facility but would be available by telephone for questions.

At 9:23 AM LPA requested a copy of the facility's Emergency Disaster Plan (LIC610E), Personnel Report (LIC500), Register of Facility Residents (LIC9020) and a copy of the facility's Liability Insurance. LPA obtained copies for review and to update the Regional Office file. At approximately 9:33 AM, LPA initiated the physical plant tour of the facility inside and out. At the entrance, LPA observed required postings on the wall by the front door and a small table with a visitor sign-in along with hand sanitizer.

The facility has an open concept layout that includes the kitchen, living area, and dining area. In the kitchen LPA observed appliances and fixtures were functional. LPA observed two refrigerators stocked with a sufficient supply of two day perishables, and the pantry and kitchen cabinets contained an adequate amount of seven day non perishable food. LPA also observed fresh fruit available in the refrigerator and on the kitchen counter. LPA observed knives and sharps were stored in a locked drawer. LPA observed the cabinet under the kitchen sink was locked and it is used to store cleaning supplies.

In the living area and dining area LPA observed the furniture to be in good repair and sit the capacity of the facility. LPA observed the fire extinguisher on a wall by the dining area. LPA observed one (1) resident in the living room watching television. The fire extinguisher was fully charged and has a last serviced date of 05/16/2025. LPA did not observe tripping hazards. (Continue to LIC809-C)