Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by administrator Robert Aquino. There is a licensing application in progress for the same address under facility Queen of Angels Care Home - 306006821, which was submitted to the Centralized Application Bureau on July 17, 2025.

There are currently six residents in care, one of which is receiving hospice care at this time. LPA observed residents relaxing in their respective bedrooms or in the facility's common living areas. Three resident interviews conducted during the visit. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with four private bedrooms and two shared rooms. There are two shared bathrooms used by residents, one of which is en-suite from the shared bedroom.

Bedrooms appear clean and sanitary. One resident uses full-length rails for postural support, with one order from hospice reviewed during the visit. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are equipped with grab bars and slip mats. Hot water temperature measured at 110F in one of the bathrooms used for personal grooming.

LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secure. There are three wall-mounted fire extinguishers present, all verified to be charged with up-to-date maintenance tags. Carbon monoxide and smoke detectors were found to be present and operational. Emergency water supplies are observed to be stored in the locked laundry room. CONTINUED ON FORM LIC809-C