Facility Evaluation Report

Licensing Program Analysts (LPA), Ahliah Sharp and Ivaishia Wright conducted an unannounced annual required visit. Upon entry, LPAs were greeted by Gina Agbayani, caregiver, and informed her of the purpose of the visit. At the time of the visit, there were three (3) staff members, and five (5) residents present one (1) was at the doctors office and returned prior to our departure.

Facility Overview: The facility is a one-story home with (6) bedrooms and (5) bathrooms, including an attached garage. There are no pools or known firearms on the premises.

Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements.

Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 117°F.

Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and exceeded the minimum of a seven-day supply of non-perishable foods in addition to emergency supply rations.