Facility Evaluation Report

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Rolando Serquinia, Administrator, and discussed the purpose of the visit.

The facility is a Residential Care Facility for the Elderly (RCFE). License capacity of (6) with a current census of (5) residents. Hospice waiver for 3. LPA conducted an overall inspection of the facility, which included, but was not limited to, the following:

LPA inspected the facility inside and out. Indoor and outdoor passageways are free of obstruction. The facility has sufficient lighting and is maintained at a comfortable temperature. Fireplace is adequately screened . Facility has no outdoor bodies of water. Facility has a covered patio area and enclosed with a self-latching back gate. However, facility auditory/alert systems were not functioning properly. Deficiency cited.

LPA inspected the kitchen. The refrigerator temperature is maintained at 39 degrees F. Hot water temperature is maintained at 107 degrees F. Facility has sufficient non-perishable and perishable food supply for the number of residents in care. Facility has sufficient cups, plates, and utensils for resident use. LPA did observed the vent above the kitchen stove was soiled with grease and debris. Deficiency cited.

LPA inspected resident bedrooms. Bedrooms are equipped with mattresses, nightstands, pillows, chairs, and storage space. Bedrooms have sufficient linen and lighting.