Facility Evaluation Report

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Assistant Administrator Della Pardo and explained the reason for the visit. The Administrator's certificate (Dianna Manalo) expires on November 15, 2027. The facility is licensed for 6 non-ambulatory residents of which 1 may be bedridden and a hospice waiver for 4. The facility is a single story home with a living room, dining room, kitchen, 5 bedrooms, 1 is shared, 2 bathrooms and a 2 car garage. The garage is kept locked and used for storage. LPA and the Administrator toured the facility. LPA observed the See Something, Say Something poster (PUB 475) posted next to the front door of the facility. LPA observed all 6 resident rooms have the required furnishings. The smoke detectors/carbon monoxide detectors tested operational. The Fire extinguisher in the hallway is fully charged. Extra linens are stored in the hall closet. LPA observed a 2 day supply of perishable food and a 7 day non-perishable food supply on hand in the kitchen. LPA observed a 3 day emergency food and water supply stored in the kitchen. LPA observed knives are kept locked in a kitchen drawer. LPA observed the medication is kept locked in a kitchen cabinet. LPA observed cleaning supplies are kept locked under the kitchen sink. The 5 burner stove in the kitchen lights unassisted. LPA observed both bathrooms are clean and operational. Hot water measured 109.9 degrees Fahrenheit in both bathrooms. LPA and the Administrator toured the backyard and the garage. LPA observed the garage is used to store extra supplies, food and furniture. The garage is kept locked. The backyard has a table with an umbrella and chairs to sit outside. Both backyard exit gates (one on each side of the house) are operational. No bodies of water observed in the backyard. No obstacles or hazards observed in the backyard. LPA reviewed facility files. The last fire drill was conducted on January 20, 2026. LPA observed the first aid kit has all the required elements. LPA reviewed 2 staff files, both staff members have the required training and CPR training. Both staff members are background cleared and associated to the facility.