Facility Evaluation Report

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by Caregiver Gelmier Gutierrez. Administrator (AD) Ferdinand Pardede arrived shortly after.

For today’s visit, LPA observed a total of five residents in care and two staff members on duty.

LPA observed the Administrator's Certificate for facility AD Ferdinand Pardede which expires on May 19, 2027.

LPA Ramirez toured the interior and exterior portions of the facility with Caregiver Gutierrez. The facility is a one-story home and is licensed for six non-ambulatory residents and zero bedridden. The facility has a Hospice waiver for three. There are a total of seven bedrooms of which six are for residents and one for staff. LPA Ramirez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. LPA observed all windows were screened. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of five restrooms. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 114.8-116.5 degrees Fahrenheit.

Food menu was also posted and visible. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Fire extinguisher was observed to be fully charged and mounted by the kitchen. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable.