Facility Evaluation Report

Licensing Program Analysts (LPAs) Abdoulaye Zerbo and Armando Perez conducted an unannounced visit for a required annual inspection . The LPAs were greeted by the caregiver Edelvyn Tolentino, notified him of the purpose for the visit and were allowed to enter the facility to conduct the inspection.

Facility Overview: The facility is a single story building with 4 residents bedrooms, 2 bathrooms, 1 staff room, a living room and dining room, an enclosed patio and a garage. There is no gated pool and there are no firearms on the premises.

Infection Control: LPAs 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. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in a cabinet under the sink and inaccessible to residents. The smoke detector and carbon monoxide detector were wired together and were operational. LPAs observed fire extinguishers to be in compliance with the department requirements and with an expiration date of 06/28/2025. LPAs observed the hot water temperature to meet requirements at 109.7°F. LPAs observed an enclosed patio to have a bed for staff. A citation will be given. LPAs observed an empty pond with a diameter of three(3) feet and dept of one and half (1.5) feet. Facility will be cited

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 a seven-day supply of non-perishable foods.