Facility Evaluation Report

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Assistant Administrator Emelita Magdaluyo and explained the reason for the vsiit. Maria Jasmin Avila's Administrator's certificate expires on June 11, 2026. The facility is licensed for 6 non-ambulatory residents of which 1 can be bedridden and a hospice waiver for 6. The facility is a one story house with 5 bedrooms, 2 bathrooms, dining room, kitchen and living room with a screened fireplace and an attached 2 car garage. The garage is kept locked and used for storage. LPA and staff toured the facility. LPA observed the garage is used to store furniture and supplies. LPA observed a 3 day emergency supply of food and water stored in the garage. LPA and Emelita Magdaluyo toured the facility. During the visit Administrator Maria Jasmin Avila arrived at the facility. LPA observed the fireplace is gas operated and the key is kept locked in the kitchen. LPA observed the See Something, Say Something poster (PUB 475) posted next to the front door. LPA observed all resident rooms have the required furnishings. LPA observed both bathrooms are clean and operational. Hot water measured 116.0 degrees Fahrenheit in both bathrooms. LPA observed clean linens stored in the hall closet. LPA observed the kitchen is clean and organized. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. Knives and sharp objects are kept locked in a kitchen cabinet. Medication is kept locked in a cabinet. LPA observed the 5 burner cook-top stove lights unassisted. The 5 burner stove has safety devices covering all the knobs to prevent resident use. The fire extinguisher in hallway next to the kitchen is fully charged. Smoke detectors/carbon monoxide detectors tested operational. Facility has a dedicated internet device for resident use. Facility has a courtyard in the front of the facility. There is a storage shed in the front courtyard used to store supplies. The storage shed is kept locked. LPA and the Assistant Administrator toured the backyard. No bodies of water observed. There is a covered patio with chairs in the backyard. The exit gate is operational. No obstacles or hazards observed in the backyard.