Facility Evaluation Report

Licensing Program Analyst (LPA) Quoc Huynh conducted an unannounced Case Management visit at 1:43PM. The LPA met with staff and explained the reason for the visit. The Licensee Rolando Lazatin arrived at 2:31PM. Entrance interview conducted.

Beginning at 1:50PM, the LPA conducted a physical plant tour with staff.

On 07/27/2006, the facility was granted a fire clearance for a total of five (5) non-ambulatory residents. The floor plan indicated Bedroom #1 was a staff room and Bedrooms #2, #3, and #4 were resident bedrooms. Currently, the facility has a total of six (6) bedrooms. Bedroom #1 is utilized as a resident bedroom and Bedroom #4 was split into two (2) bedrooms with a built-in wall. The Licensee stated a building permit was not needed and did not have documentation. Staff confirmed that the new staff room was a previous hallway walk-in closet. Further record review revealed that on 06/28/2019, the facility had six (6) residents, however, it was only cleared for a capacity of five (5).

On 08/07/2024, LPA Sandra Urena and Erica Mosley conducted an annual visit and observed the facility’s floor plan did not reflect what was on file with the Department. The facility was cited with a plan of correction to provide the Department with an updated floor plan and obtain a new fire clearance. The plan of correction was not met as a new fire clearance was not obtained.