Facility Evaluation Report

Licensing Program Analyst(s) (LPA)s Mary Flores and Jewel Baptiste conducted a plan of correction visit at the facility to follow up on deficiencies cited on 9/16/21.

On 9/16/21 LPA Flores conducted an unannounced annual visit during the visit the following deficiencies and technical violations were given:

During today's visit LPAs conducted a tour of the facility with Surya Correa caregiver and observed the following corrections for deficiencies cited on 9/16/21:

80087(g)(1) Buildings and Grounds - Licensee did not ensure knives and sharps were kept locked. LPA observed knives/sharps drawer was locked and open during the visit.

85076(d)(1) Food Service - Licensee did not ensure facility had sufficient perishable foods for at least 2 days. LPA observed sufficient perishable foods for at least 2 days during this visit.

80087(a) Buildings and Grounds - Facility's backyard door handle fell down during the visit of 9/16/21. LPA Flores observed door handle was fixed after door was open.

80088(d) Furniture, Fixtures, Equipment, and Supplies - Bedroom #2 did have sufficient lighting during the visit.

Deficiencies have been cleared per Title 22 Regulations.

Exit interview was conducted with Marites Gacayan and a copy of this report, and clearance letter were provided.