Facility Evaluation Report

Licensing Program Analyst (LPA) Michelle Echeverria arrived unannounced to conduct the required annual visit to the facility. LPA met with Caregivers, Adelaida Dy and Doroteo Zapanta and introduced self and stated purpose of the visit. LPA phone called Licensee/Administrator, Kelvin Mate and informed him about the purpose of the visit. LPA was informed that there are currently 4 residents in care who are in the facility.

The facility has 4 resident bedrooms, 3 resident bathrooms, kitchen, dining area, living room, laundry room, attached garage, and backyard with a shed. LPA completed a walk through of facility, and review of records.

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 72 degrees fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and sufficient lighting. LPA inspected resident bathrooms; bathrooms were clean and appliances were found functional. Water temperature tested at 139 degrees fahrenheit without warning signs posted. Deficiency issued. The facility is equipped with operational smoke detectors, carbon monoxide alarms, fire extinguisher and first aid kit. Posters such as; the personal rights, ombudsman, and license were posted in a common area. LPA also observed cleaning supplies, toxins, sharps, and other dangerous items locked in cabinets made inaccessible to residents. There was a designated storage space for resident/staff files. Medications were observed secured and inaccessible to residents. There are no guns or ammunition in the facility.

Food Service : Non-perishable and perishable food supply is sufficient for number of residents in care. Dishes, cups, and utensils were also stored properly.