Facility Evaluation Report

Licensing Program Analyst (LPA) Jose Tan conducted an unannounced Required One (1) year inspection. Upon arrival, LPA was greeted by staff Corazon Zolita, who contacted the Administrator Beatriz Vasquez and arrived about 20 minutes later. LPA explained the reason for the visit.

At 9:08 AM, LPA Tan conducted a physical plant tour of the facility inside and out. The following was observed: LPA observed appropriate postings by the entry and a visitor sign-in log with a digital thermometer affixed to a wall.

Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of 2-day perishable and 7-day non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen and medications were observed locked in a kitchen cabinet. Cleaning supplies were observed locked in kitchen cabinet under the sink.

Bedrooms: There are five (5) bedrooms designated for residents' use of which one (1) is shared. Resident bedrooms were properly furnished with appropriate bedding, linens, sufficient lighting and required furniture. Hallway cabinets by the bedrooms were observed to store extra linens. The auditory alarms on all exit doors were on and functional at the time of visit.

Bathrooms: There are three full (3) bathrooms and one (1) half bathroom. One (1) full bathroom is located in the shared bedroom. Bathrooms were properly supplied with paper towels, hand soap, toilet paper and grab bars. LPA observed the bathroom fixtures to be functional. Hot water temperature was measured at a range of 111.2°F to 117.8°F and within regulation. (continued on LIC 809-C)