Facility Evaluation Report

Licensing Program Analyst (LPA) Hiratsuka visited the facility to conduct an annual visit. LPA met with Shaina Lisnawati and Francisca Ingegneri.

LPA toured the facility including common areas, dining area, bedrooms, bathrooms, laundry room, kitchen, and yard. Food supplies are adequate to meet the requirement of 2 days perishable and 7 days non-perishable supplies and of good quality and variety. Smoke detectors installed and functioning, fire extinguisher present and charged, carbon monoxide detectors installed. Medications are centrally stored, locked and logged. Cleaners, potentially hazardous items and substances are secured.

LPA reviewed two staff files and two resident files. Files appear to include appropriate documentation.

The facility appears to be in substantial compliance with the regulations at this time. No deficiencies were cited at this visit.