Facility Evaluation Report

Licensing Program Analyst (LPA) Javina George conducted an unannounced annual/1 year required visit on 04/25/23 at 1:45pm. LPA was granted entry by House Manager Lourdes Pagulayan, who was informed of the purpose of the visit. The Administrator was not available at the time of LPAs visit.

LPA conducted a tour of the interior and exterior of the facility and observed the following: the home has two stories consisting of (4) bedrooms, (3) bathrooms, office, formal dining room, den, backyard and 2 car garage.

Infection Control: the facility has an approved mitigation plan on file that was approved on 3/16/2021. LPA observed the facility to still follow their mitigation plan and conducting covid protocol such as temperature checks, sanitizing upon entry. LPA did explain that it is no longer required, however it is up to the facility and their comfort level.

Physical Plant: LPA observed the clients bedrooms which contained the required furniture. The interior and the exterior, including the floor, doors and windows were observed to be clean, clutter as well as odor free. The Fixtures and furniture were observed to be in good repair. The facility does not have a pool, or any other bodies of water on the premises. The water temperature was tested and was found to be within regulatory limits 106.5-108.2 degrees Fahrenheit.

Food Service: LPA observed the kitchen to be clean and possess equipment in good working condition. LPA observed the facility had the required 2-day perishable and 7-day non-perishable food supplies. The facility reports conduct their shopping every other week. The facility is due to go shopping this Friday 4/28/23. The sharp and dangerous objects are kept locked in the kitchen in the second drawer next to the stove.

Care & Supervision / Administration: Emergency exiting plans, emergency telephone numbers and personal rights were found posted in the facility on the wall inside of the kitchen/dining area.