Facility Evaluation Report

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit for a required annual inspection . The LPA was greeted by Licensee/Administrator Borka Sapungin, notified them of the purpose for the visit and was allowed to enter the facility to conduct the inspection.

Facility Overview: The facility is a single- story building with 3 residents' bedrooms, 2 bathrooms, a dinning room, a kitchen, an outdoor area, and a garage. There is no gated pool and there are no firearms on the premises.

Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance.

Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in the garage and inaccessible to residents in care. The smoke detectors and carbon monoxide detectors were operable. LPA also observed a charged fire extinguisher mounted in one of the hallways. The water temperature was tested within regulations measuring 120.0 F