Facility Evaluation Report

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced visit at this facility for a One (1) year Required visit. LPA met with the administrator Alma Guinto and explained the purpose of the visit.

A tour of the physical plant was conducted at 9:18 AM. The facility has four (4) bedrooms and two (2) bathrooms currently occupying two (2) residents on two (2) shared and one (1) private room. One (1) bedroom is designated for staff use. The facility fire cleared for three (3) non-ambulatory and two (2) ambulatory residents.

There is only one entrance being utilized at the facility. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Mitigation plan and Infection plan.

Physical environment was checked for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings, and doors were checked, the following was noted:

Living and dining room furniture were also checked. The living room is neat and clean along with the family room. The facility maintains a comfortable temperature at 75°F. The carbon monoxide and smoke detector are tested and observed to be operational. Smoke detectors are hardwired and interconnected. Fire extinguisher was observed to be full and last bought on 03/17/24.

The backyard There is a tool shed at the backyard that observed to be locked during visit. There is a make shift extension accessible through the kitchen with furniture for the residents and there is a shaded area at the front porch. There is no body of water at the facility.