Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced on 1/8/25 at 2:00PM to conduct a Required - 1 Year annual inspection visit. LPA met with Emilinda Perez, Caregiver and Thelma Casugay explained the purpose of the visit.

The facility is licensed for a capacity of 6 residents of which 4 may be non-ambulatory and 2 maybe bedridden. Licensing fees are current. Administrator certificate expires 8/9/26 for Thelma Casugay..

LPA observed an Infection Control Plan during this visit. LPA observed residents participating in group and individual activities during this visit. LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed kitchen, dining area, 4 bedrooms and 3 bathrooms, storage areas, laundry and lighting throughout the facility. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises. The most recent emergency drill was conducted on 12/8/24.

The temperature inside the facility was observed to be at 70*F which is within the required range of 68-85*F. The hot water temperature was measured at 115.6*F which is within the required range of 105-120*F. LPA observed fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility.

LPA observed the centrally stored medications area to be locked and inaccessible to residents. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide.