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 five clients of which three can be non-ambulatory. The facility currently has three clients. Administrator (AD) Lommel Tumbokon was present to conduct facility tour.

LPA toured the physical plant, checked food service, and facility documentation. The facility consists of 5 client bedrooms, a living room/dining room area, exercise room, sensory room, medication room, and kitchen as well as three bathrooms. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each client comfortably. Client 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 degrees F and 112.2 degrees F in all bathrooms. Client bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alerts were operational during today's visit. LPA toured the kitchen and observed sharps locked in a box during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Smoke detectors tested operational during today's visit. Fire extinguishers were fully charged. LPA reviewed the infection control and emergency disaster plans and plans are complete and thorough. Facility conducts monthly emergency drills with the last drill conducted on 3/4/2026. Outside grounds were toured. Walkways around the facility were clear of hazards. First aid kit contained all required items including tweezers, scissors and thermometer. Facility conducts activities in the form of outings and sensory therapy. There is shaded outdoor seating for clients. LPA observed the emergency food and water supply.