Facility Evaluation Report

On 5/19/23 at 8:52 am, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced required annual visit with a primary focus on Infection Control measures using the new CARE Inspection Tools. Upon arrival at the facility, Rizalinda Cay-an, Caregiver called the Administrator Johnette Bellosillo. LPA explained the purpose of this visit to the licensee and was granted entry. Census is 4.

The facility has an approve mitigation plan report.

LPA Shirley and Staff Sally, (Rizalinda Cayan-an), toured the inside and outside grounds of the facility.

The facility is licensed to serve four (4) non-ambulatory clients ages 18-59, approved for non-ambulatory with a hospice waiver of two clients. The facility is vendored by the Harbor Regional Center.

During the tour, LPA observed the facility’s infection control practices. PPE supplies are readily available to staff, and an additional 30-day supply of PPE is stored in the garage. Sufficient paper, cleaning, and disinfecting supplies were observed. The facility has one central entry and a designated visitation area. LPA observed required postings throughout the facility.

LPA observed the facility consists of living room, office area, TV room, kitchen, dining area, medication closet, two (2) bathrooms, four (4) client bedrooms, washer and dryer in garage, two (2) garages (one used for storage), and backyard. Centrally stored medications are inaccessible to clients. Disinfects, cleaning solutions, detergent, toxins are inaccessible to clients. There is at least a one-week supply of nonperishable and two-day supply of perishable foods. The facility is maintained at a comfortable temperature. Hot water temperatures in both bathrooms measures at 112.2 degrees Fahrenheit.