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. The Administrator, Cybele Magtibay has an Administrator's certificate that expires on September 27, 2026. The facility is a single story home with 8 bedrooms, 6 bathrooms, an office, living/dining room, kitchen, and an attached 3 car garage. Garage is being used for storage of food and supplies and is inaccessible to residents. Two of the bedrooms are for caregivers. Facility is licensed for 6 non-ambulatory residents and a hospice waiver for 6. LPA met with the Administrator and explained the reason for the visit. LPA and 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 the required postings on the wall of the kitchen, visible from the dining room. LPA observed the fire extinguisher in the kitchen and resident hallway are fully charged. LPA observed a two day perishable and a seven day non-perishable food supply in the kitchen. The 4 burner gas stove lights unassisted. Knives and sharp objects are kept locked in a kitchen drawer. LPA observed the kitchen is clean and organized. Medications are kept locked in a kitchen cabinet. LPA observed the garage is kept locked and used for storage. LPA observed emergency food and water (3 day supply) stored in the garage. LPA observed old furniture and supplies stored in the garage. LPA observed all resident rooms have the required furnishings and linens. Smoke detectors/carbon monoxide detectors tested operational. LPA observed all bathrooms are clean and operational. Hot water measured 114.2 degrees Fahrenheit in bathroom 1. The last fire drill was conducted on December 15, 2025. LPA observed the backyard has no bodies of water. The exit gate is operational. There is a table with 4 chairs and an umbrella for residents to sit outside. No obstacles or hazards observed in the backyard. LPA reviewed 6 resident files and medications, no discrepancies observed. LPA reviewed 2 staff files, both staff members have the required training including CPR training.