Facility Evaluation Report

On today's date Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purpose of conducting the required annual inspection. LPA was greeted and granted entry by Care Giver (CG) Remedios Baculong after explaining the purpose for the visit. Administrator (AD) Mindy Fajardo was notified via telephone, and arrived shortly after to assist with the inspection. LPA observed that Administrator (AD) Mindy Fajardo has a valid Administrator certificate which expires May 22, 2027.

LPA Vanegas began a tour of the facility and the facility consist of the following. It is a single story house with four bedrooms, one of which is a staff bedroom, two bathrooms one of which is a staff and guest bathroom, the other is for resident use only, a living room, a dining room, a kitchen, a laundry room, and an attached two car garage.

LPA Vanegas observed one resident in care, lounging in the respective common areas, and in their room. LPA Vanegas observed the kitchen area to be clean and free of any mildew and debris. LPA Vanegas observed sharp utensils to be locked away and inaccessible to residents in care. LPA Vanegas observed the refrigerator, gas stove, microwave and dishwasher all to test operational. LPA Vanegas observed a two day supply of perishable food, and a seven day supply of non-perishable food.

LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall by the entryway of the facility. LPA inspected all five resident bedrooms, and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings such as a bed, a chair, chest of drawers, and a reading lamp. All resident beds had clean linens in good repair; meaning no strains or tares. LPA observed additional linens are stored in a hallway closet. LPA inspected both bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars, slip resistant floor mats, and a shower chair. Faucets and toilets were operational. Hot water temperature measured between 108.5 and 111.5 degrees Fahrenheit.