Facility Evaluation Report

On 8/28/2023, Licensing Program Analyst (LPA) Janette Romero arrived unannounced at the facility to conduct an annual required visit. LPA was greeted and granted entry by Caregiver Soledad Camalig who was informed of the purpose of visit. During the visit, there was three (3) residents and two (2) staff present. LPA was informed three (3) residents were at day program.

The facility is approved to care for six (6) non-ambulatory residents and has a hospice waiver for six (6). The facility is made up of four (4) resident bedrooms, two (2) resident bathrooms, a kitchen, dining room, living/family area, laundry room and garage.

During the visit, LPA observed the following:

Kitchen: LPA observed kitchen to be clean. Food is stored in a safe and healthful manner. Sharps are secured in a locked kitchen drawer. The facility has a 2-day supply of perishable food items and 7-day supply of non-perishable food items.

Dining and Living room: LPA toured the dining and living/family room area. LPA observed areas to be clean and furniture in good condition. LPA observed residents resting in the living room and sleeping in their rooms. Fire extinguisher is charged and mounted in the dining room.

Hallway : LPA observed hallway to be clean with no pathway obstruction. Carbon monoxide and smoke detector were tested and functioning properly.