Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso conducted a Required- 1 Year visit, on 10/2/23 at approximately 10:20am, and met with caregivers Angelina Manabat, and Romeo Manabat. Caregiver Angelina contacted the Administrator and notified them that the LPA was at the facility. The Administrator Charmaine Mendaros arrived within an hour of being notified that the LPA was at the facility.

Facility has an infection control plan as required. Facility has an emergency and disaster plan as required. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements.

Fire clearance is approved for one (1) ambulatory, and five (5) non-ambulatory, of which three (3) may be bedridden ; 1 bedridden in room #5, 2 bedridden in room #4, 1 non-ambulatory in room #2,

1 non-ambulatory in room #3, and 1 ambulatory in room #1. Fire extinguisher expires soon, one(1) scheduled to be serviced and tagged this Thursday,10/5/23.

Facility was found to be clean, orderly,and at a comfortable temperature with all exits free from obstruction. Hot water was checked at 117.F which is within regulation. Medications were stored and locked making them inaccessible to residents. All toxins and cleaners were stored in locked cabinets, and inaccessible to residents in care.

There was a sufficient supply of hygiene products, cleaning supplies, and paper products for use as needed. All bathrooms had grab bars, and non-slip mat/flooring for bathing/showering as needed. Facility has a sufficient supply of personal protective equipment(PPE) for use as needed. LPA observed sufficient supply of food, perishable and non-perishable.

The LPA reviewed five (5) resident files. LPA reviewed five(5) of five(5) staff files. All five (5) staff have criminal record clearance as required. Per record reviews, three (3) staff are associated as required.