Facility Evaluation Report

Licensing Program Analyst’s (LPAs) Carmen Lopez and Eryn Kane, conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA’s identified themselves and were granted entry by caregiver’s Emelinda and Joseph Pagulayan. LPAs discussed the purpose of the visit with licensee/administrator Eunice Ambal who later arrived and joined the visit.

According to the facility’s license, there may be a maximum of 6 residents, all of whom may be non-ambulatory, and is approved for one bedridden resident in bedroom #2, in at any given time at the facility site. The facility is approved for 3 hospice residents. During today’s inspection, the facility’s current census is 6 residents living at the facility. There were 6 residents present at the facility site during the inspection.

LPAs inspected 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. Resident’s bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and activities.

The facility’s ambient internal temperature was comfortable and compliant, at 71º Fahrenheit (F). Hot water temperature at taps accessible to residents were also compliant.