Facility Evaluation Report

Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced continuation of the annual inspection. LPA met with Dennis Bonifacio and Susan Nuguid and disclosed the reason for the visit. LPA reviewed 2 residents' files and observed that R5 does not have an updated Appraisal Needs and Services (LIC 625) as well as a hospice care plan. LPA also reviewed the medication and the medication record for proper documentation. LPA observed that the R4 Medication record is incomplete. LPA also observed that the facility does not have an activity calendar in place. LPA also noted that there were no fire drills conducted.

Exit interview conducted. citations issued, Copy of report provided.