Facility Evaluation Report

Licensing Program Analyst (LPA) Edward Tapia made an unannounced required annual inspection at this facility. LPA met with staff Reynaldo Francisco and stated the purpose of this visit. Administrator Annamarie Tomilloso arrived during the visit at 11:20 AM and provided assistance.

The facility is a single level structure and licensed for six ambulatory. This facility offers a Level IV- I service.

About 10:53 AM LPA Tapia was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. For this visit, LPA observed four clients in care and two staff members on the duty. LPA toured the interior and exterior portions of the facility. There were six private client rooms. One room was for staff and one of the client rooms was vacant. Vacant room was observed to have cough syrup medication and was immediately removed and locked. Residents rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Manual smoke detectors, carbon monoxide were tested to be operational. Bathroom (1) was observed to be in good repair and hot water was measured at 121.8 degrees Fahrenheit. Bathroom (2) was observed to be in good repair and provided with grab bars and hot water was measured at 121.8 degrees Fahrenheit. LPA noticed lights in restroom (2) were not fully operational and requested for them to be replaced. Facility met the minimum two day supply of perishable and seven day supply of non-perishable food stock requirements, cleaning supplies and sharp items were inaccessible to clients in care. Facility had adequate supplies of personal protective equipment in place. Fire extinguishers were on observed. For the exterior portion, facility had outside furniture in good repair; and grounds were free of tripping hazards. Facility was observed to have a 2 car garage used as a kitchen with operating stove, sink, refrigerator and had an operating washer and dryer. Garage also had a restroom with shower for staff use. Kitchen was in good repair with knifes kept locked. LPA Tapia reviewed the COVID 19 mitigation plan of the facility.