Facility Evaluation Report

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Administrator Sherwin Marcos.

According to the facility’s license, the facility has a maximum capacity of 6 residents of whom all may be non-ambulatory, of which one 1 resident may be bedridden. There is an approved hospice waiver for three 3 residents.

LPA, accompanied by Administrator toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities.

The internal ambient temperature was comfortable and compliant. Hot water temperature at taps accessible to clients were all compliant. There were at least 2 days of perishable food, and at least 7 days non-perishable food present. Cooking and dining equipment and utensils were present. There were no sharp objects, open-faced fireplaces or heaters observed accessible to residents. Medications were labeled, as required, and stored in locked areas.