Facility Evaluation Report

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for six non-ambulatory residents. Facility has an approved hospice waiver for six residents and the home currently has four residents, with two residents on hospice. Administrator (AD) Benjie Dizon arrived shortly to conduct facility tour. AD provided updated liability insurance that expires on 2/26/2026.

LPA along with AD toured the facility at 9:00 AM. LPA toured the physical plant, checked food service, and facility documentation. The facility is a two story house with an attached garage with 5 resident bedrooms, 4 full bathrooms, 1 half restroom, a living room, a dining room, a kitchen on the first floor. The second floor of the facility is occupied by live in staff with a studio style bedroom and 1 full bathroom. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 107.9 degrees F and 114.4 degrees F in all bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alarms were operational during today's visit. LPA toured the kitchen and observed sharps locked in a cabinet during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Smoke detectors tested operational during today's visit. Fire extinguishers were fully charged.