Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Administrator/Licensee Marilou Panaligan and granted entry to the facility. Licensed capacity is (6) current census (6). LPA was accompanied by Administrator/Licensee Marilou Panaligan to conduct a general overall inspection, which included, but was not limited to, the following:

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). The facility is maintained at a comfortable temperature. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. During facility tour, LPA Rico observed boxes and furniture blocking emergency exit for bedridden room. In addition, LPA observed the facility kitchen floor and cabinets dirty. LPA requested the facility to be deep clean, de- clutter and organize. Residents’ personal hygiene was not labeled. Lose toothbrushes were mixed with other residents items. Staff were unable to tell which personal items belong to what resident. LPA requested emergency food, water and supplies to be placed in a storage box to be made available. Furthermore, LPA Rico observed the facility had five out of the six residents with full bed rails. During record review the five residents did not have a physician order nor hospice care plan indicating they require full bed rails. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a variety of food available for residents. Dishes, cups, and utensils were also stored properly.

Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week.