Facility Evaluation Report

Licensing Program Analyst (LPA) Elsie Campos arrived at the facility unannounced to conduct a required Annual visit. This annual had a specific emphasis on infection control practices and procedures. The LPA met with Licensed Vocational Nurse (LVN) Alexis Calicdan whom contacted the Administrator over the phone and explained the reason for the visit. The Administrator was not present and authorized Alexis Calicdan to sign the report.

The LPA toured the physical plant areas inside and outside, with Staff at 10:30 a.m., to ensure there are no health and safety hazards.

BEDROOMS: There are five (5) bedrooms designated for resident use and one (1) open room designated for staff use, staff room is used for staff breaks. The facility has furnished each room with clean linens, appropriate furnishings, and sufficient lighting for resident use. All resident rooms are private. BATHROOMS The facility has one (1) large resident bathroom and one (1) staff/visitor bathroom. Bathrooms are clean, sanitary, and in operating condition with grab bars and non-skid surfaces. The LPA observed sufficient amounts of soap and paper products. Bathroom hot water measured at 118.0 and 117.5 degrees Fahrenheit between 10:40 a.m. and 10:49 a.m. KITCHEN: Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Knives, medications, and chemicals were locked and inaccessible. COMMON SPACES: The common spaces included the living room and dining area. All areas were clean, sanitary and in good repair. Smoke detectors are hardwired and interconnected. The fire extinguisher was observed to be full and last serviced on 3/11/2022. The LPA observed required postings on the wall at the entrance. Flooring was checked for cleanliness and appeared in good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition.