Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Marites Chiapoco. LPA also spoke briefly with Administrator Elizabeth Velasco via phone.

According to the facility’s license, the facility has a maximum capacity of six (6) clients, of whom all may be ambulatory or non-ambulatory, but none may be bedridden. Per LPA observation, LIC602 Physician’s Reports, and staff interview, as of today’s date, there were six (6) clients in care [Client #1 (C1) through Client #6 (C6)], and all were non-ambulatory. [See LIC 811 Confidential Names List for a description of select person identifiers used in this report.] LPA reviewed all available client records. LPA reviewed administrative and training records for all active staff. The clients who were present did not have the verbal skills to be qualified as reliable historians/interviewees. However, LPA found all clients he encountered were safe, calm, alert, and cleanly dressed and cleanly groomed. LPA also interviewed multiple staff who were present.

The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were working. Extra linens, hygiene, and Personal Protective Equipment (PPE) supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities.