Facility Evaluation Report

Licensing Program Analyst (LPA) Nune Margaryan conducted an Annual Required visit and inspection of the facility. LPA met with the Administrator Rosemarie A Honrado and Licensee Adelaida Asuncion. LPA explained the purpose of the visit.

The facility is licensed to serve Dementia residents, ages 60 and above, approved for two (2) non-ambulatory and four (4) ambulatory residents. Currently, there is no hospice resident in placement.

During the visit, LPA toured the facility inside and outside, and reviewed 2 residents files. LPA requested and obtained a copies of residents files.

The facility is a single-story house located in a residential neighborhood. It consists of five (5) bedrooms including three (3) resident bedrooms, one (1) staff room, one (1) room for family member; three (3) bathrooms, kitchen, dining room, living room, and detached garage.

Due to insufficient time and information during the visit at this time, LPA will return at a later time to complete annual inspection. Exit interview was conducted with Adelaida Asuncion and the copy of this report provided.