Facility Evaluation Report

On today's date Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of completing an annual inspection. Upon arrival LPA was greeted and granted entry to the facility by care giving staff. LPA explained the purpose of the visit and Administrator (AD) Raymond Tinio was notified via telephone, AD arrived shortly afterword in order to assist with the annual visit. LPA began a tour of the facility and observed the following. AD Raymond Tinio has a valid Administrator certificate valid from September 24,2024 through September 23, 2026.

The facility is a one storied home with a total of five bedrooms, four of which are resident rooms and one of which is for live in staff. The facility is equipped with two bathrooms, and an attached two car garage. LPA observed the kitchen area to be clean and free of mildew and debris. LPA observed a microwave, refrigerator, dishwasher, and a gas stove located in the kitchen area. All appeared to be in good repair and tested operational. LPA observed the facility to have a two day supply of perishable food and a seven day supply of non-perishable food. LPA observed all toxins and sharps to be locked away and inaccessible to residents in care.

LPA observed all resident rooms to be large enough to walk about freely, and be free of any obstructions, hazards, and toxins. LPA observed all resident rooms to have all required furnishings such as a chair, a lamp, a chest of drawers, a bed, clean linens in good repair; meaning no strains or tears, and enough storage space to store personal belongings. LPA observed all resident restrooms to be clean and free of debris and mildew. LPA observed all water faucets and toilets to be operational. LPA observed restrooms to have all required furnishings such as grab bars, slip resistant floor matts, and a shower chair. Hot water temperature tested between 113.4 and 114.1 degrees Fahrenheit. CONTINUED ON LIC809-C