Facility Evaluation Report

Licensing Program Analyst (LPA) Abeye Duguma met with Jorge Aquino for a Required One (01) Year visit. LPA contacted the administrator Silica Bungabong who designated Jorge Aquino to sign and accept the report. LPA explained the reason for the visit. A tour of the physical plant was conducted at around 10:00 AM and the following was noted:

There is one entrance being utilized at the facility. Facility has five (05) bedrooms and two (02) full bathrooms. One (01) out of five (05) bedrooms is semi-private and the remaining are all private single occupancy. The facility is fire cleared for six (06) non-ambulatory of which one (01) may be bedridden and has a hospice waiver for six (06). The facility is currently occupying four (04) residents.

The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. The garage is currently being used for storage. Laundry detergents, cleaning agents and other toxins are locked away.

Kitchen is sufficiently stocked with at least two (02) days perishable and seven (07) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents.