Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Administrator Matthew Magsambol, Continual Administrator's Certification expires for Rosario Magsambol expires 06/21/2025. There are currently 3 residents who reside at this home and there is 0 residents on hospice at this time. 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. The facility has adequate 2 day perishable and 7 day non perishable food supply.

Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector. Water temperature was tested at 113 degrees. First Aid kit is on site and complete. LPA observed facility back window screen to be off the tracks and in disrepair. LPA observed facility hallway bathroom sink is plugged and fills with water. LPA observed resident back female resident bathroom vents to be extremely dirty. LPA observed several resident dressers in disrepair. LPA observed a hole under back female resident bathroom under the toilet. LPA observed hallway vent in disrepair and very dirty. LPA observed webs throughout facility, and dressers are dusty. LPA Hurt observed hallway bathroom trash with no lid. LPA observed meat covered in ice inside facility refrigerator frozen in a plastic container with only covered in foil. LPA observed sausages inside freezer with open with no covering. LPA Hurt observed dry fish in bottom refrigerator drawer with no label or date. LPA observed two dogs in the backyard one appeared to be very thing and not maintained. LPA observed disinfectant under the hallway bathroom cabinet accessible to residents.