Facility Evaluation Report

Licensing Prog ram Analysts (LPAs) Nancy Guillen and Kevin Saborit-Guasch made an unannounced visit for the purpose of conducting a required annual inspection. LPAs were greeted and granted entry by care provider Noel Mallari after explaining the purpose of the visit. Administrator (AD) Maria Emeterio was notified via telephone and later arrived to assist with the inspection. LPAs observed the Administrator certificate was current and expires August 15, 2026. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents, of which one may be bedridden, with a hospice waiver for six. The facility is a one-story home with four resident bedrooms, one staff bedroom, two bathrooms, and an attached garage.

During the inspection, LPAs and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following:

LPAs observed a residents watching television in the living room and resting in their respective bedrooms. LPAs observed six residents in care and four staff present. LPAs observed the See Something Say Something Poster (PUB 475) mounted on the wall in the dining room. All resident bedrooms had the required furnishings. LPAs observed all resident beds had linens and blankets with additional linens stored in the hallway storage closet. LPAs observed bathrooms were clean and equipped with grab bars and non skid floor mats. LPAs observed all windows were appropriately screened. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 116.6 and 117.1 degrees Fahrenheit. LPAs toured the outside of the facility and observed outdoor passageways were free of obstruction. LPAs observed the backyard had a shaded sitting area with furniture for resident use. LPAs observed fireplace in dining area had appropriate screening.