Facility Evaluation Report

Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced annual inspection visit at the facility. Upon arrival, LPA Haddadin was greeted by Administrator (AD) Jay Parungao, who granted access to the premises. LPA Haddadin explained the purpose of the visit.

LPA Haddadin, accompanied by AD Parungao, toured the interior and exterior portions of the facility. The following observations were made:

The facility is a single-story residence featuring four (4) resident bedrooms, two (2) bathrooms, a staff room, a kitchen, a dining room, a living room, and an attached garage. At the time of the visit, three (3) residents were present and were observed relaxing in their respective rooms.

Resident bedrooms were furnished with beds, chairs, clean linens, and adequate storage space. All rooms were free of tripping hazards. Manual smoke detectors, carbon monoxide detectors, and exit alarms were tested and confirmed to be operational. The bathrooms were observed to be in good repair and equipped with grab bars. The hot water temperature was measured at 115.3∘F. The facility met the minimum food stock requirements, maintaining a two-day supply of perishable items and a seven-day supply of non-perishable items.

A fire extinguisher was observed with a stated purchase date of August 29, 2024.

The exterior portion of the facility included outdoor furniture in good condition. The grounds were free of tripping hazards and provided ample space for activities.

The kitchen was found to be in good repair. Cleaning supplies and sharp items were stored in a manner that made them inaccessible to residents in care. Medications were stored securely in a locked location in the hallway.