Facility Evaluation Report

Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced to conduct an annual inspection on 7/11/2023. LPA met with Administrator, Rustico Agcaoili Jr. and explained the purpose of today’s visit.

Administrator holds current certificate # 6033898735 and expires on 10/1/2024. The facility is licensed for 3 ambulatory residents and 1 non-ambulatory resident. The facility currently has 3 clients residing at the home at this time. Administrator will assist LPA with today’s inspection.

LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, client bedrooms, client bathrooms, laundry room, and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility is clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. The hot water temperature was observed to be 105.8 degrees Fahrenheit, which is within the required regulation of 105 to 120 degrees Fahrenheit. Facility thermostat observed at 74 degrees Fahrenheit. Food supply is adequate for 2-day perishable and 7-day nonperishable. LPA observed knives and toxins to be locked away and inaccessible to clients. Smoke and carbon detectors were in good repair. Fire extinguisher and first aid kit was up to date. LPA checked medication storage and found medication to be locked away and inaccessible to clients. Proof of current liability insurance was observed. Proof of current liability insurance was observed. A full Care Tool Inspection was completed at facility.