Facility Evaluation Report

Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA Domingo was welcomed by, identified herself to, and discussed the purpose of the visit with Dan Louie Estavillo House Manager. Licensee/Administrator Maricon Geronimo joined us for the tour.

According to the facility’s license, the facility was approved for six (6) clients in total, of which all must be ambulatory. there were a total of five (5) clients in care, and per medical records, all were ambulatory.

LPA, accompanied by licensee’s staff, toured the interior and exterior of the facility, and inspected each room. 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 in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Call box was available in each resident unit and were tested for functionality. Resident's room temperatures were within a comfortable range. The facility’s ambient internal temperature was 70 F. Hot water temperature at taps accessible to clients were all compliant: Kitchen sink was 110 F, Bathroom #1 sink was 110 F.

Refrigerator temperature was 35 F and freezer temperature was - 0 F. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas.