Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted and granted entry by Staff Dory Lacwasan, and LPA explained the purpose of the inspection. Administrator (AD) Cherry Aguila arrived at approximately 2:30 p.m.

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

This is a one-story home with four resident bedrooms, three bathrooms, and attached two-car garage. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets. In the hallway storage, LPA observed a dresser and personal items, including clothing and hygiene items. Per Staff Lacwasan, the items belong to them as they are currently residing at the facility and sleep on the couch; a Deficiency was cited on today’s date. The backyard has a shaded sitting area. LPA observed residents watching television in the living room and resting in their respective bedrooms. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested at 113.7 degrees Fahrenheit. Per Staff Lacwasan, the master bedroom bathroom located within two residents bedroom is currently used as the staff bathroom, a Deficiency was cited on today’s date. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. Medication cabinet was observed to be locked. (Cont. LIC809-C)