Facility Evaluation Report

Licensing Prog ram Analyst (LPA) Nancy Guillen made an unannounced visit for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by care provider after explaining the purpose of the visit. Administrator (AD) Joselolito Soliven's certificate was current with an expiration date of August 15, 2026.

This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents with a hospice waiver for three. The facility is a one-story home with three resident bedrooms, three staff bedrooms, two bathrooms, one staff bathroom, kitchen, dining and an attached garage.

During the inspection, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following:

LPA observed residents watching television in the living room. LPA observed two residents in care and two staff present. LPA observed the See Something Say Something Poster (PUB 475) mounted on the wall by the entry way to the facility. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets with additional linens stored in resident bedroom closet. LPA observed bathrooms were clean and equipped with grab bars and non skid floor mats. LPA observed all windows were appropriately screened. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 108.8 and 116.6 degrees Fahrenheit.