Facility Evaluation Report

Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced Annual Required visit and inspection of the facility. LPA arrived at the facility at 10:50 AM and rang the doorbell. Through the glass door, LPA observed that the facility was undergoing renovations and that no residents were present at the time of the visit.LPA contacted and met with the Administrator, Editha Tagum. At approximately 11:15 AM, with the Administrator’s assistance, LPA conducted a tour of the physical plant.LPA observed that the facility floors were covered with red rosin paper due to ongoing renovations. Required postings were observed in the dining area. Functional smoke alarms and carbon monoxide detectors were present throughout the facility. LPA observed a fire extinguisher with a purchase date of 05/18/2026.LPA observed the kitchen to be clean and all kitchen appliances to be functional. Knives were stored in a locked drawer in the kitchen. Bedrooms: There are six (6) bedrooms in the facility. Five (5) bedrooms are designated for resident use, and one (1) bedroom is designated for staff use. All bedrooms were furnished with appropriate bedding and linens and had sufficient lighting. LPA observed that Bedrooms #2, #3, and #4 had open ceilings due to ongoing ceiling repairs. Bathrooms: There are three (3) bathrooms designated for resident use. Due to the renovations, the facility water supply was temporarily shut off; therefore, LPA was unable to measure the hot water temperature at the time of the visit. Common Areas: The common areas included the living room and dining area, both of which were properly furnished. The auditory alarms on all exit doors were operational and functioning at the time of the visit. The dining room table was sufficient to accommodate the licensed capacity of the facility. Seating, including couches, was observed to be in good repair and adequate for the facility’s capacity.(Continue on 809C)