Facility Evaluation Report

Licensing Program Analysts (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Licensee, Benjamin Macasaet, Continual Administrator's Certification for Richard Macasaet expires 05/16/2024. There are currently 24 residents who reside at this home. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable.

Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs. Toxins and cleaning supplies are locked and inaccessible. This facility performs disaster drills as required. Water temperature was tested at 125 degrees. First Aid kit is not complete. LPA Hurt observed facility resident dressers to be broken, facility bathroom to need flooring repairs. LPA Hurt observed 4 out of 4 facility fire extinguishers have not been serviced within the required year. LPA Hurt observed the facility resident bedroom walls to be extremely dirty.

The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.

Exit interview conducted with Licensee, Benjamin, Mascasaet and copy of report left at facility