Facility Evaluation Report

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Caregivers Gloria Pascua, Loida Sanga, and Rowena Estacio. Administrator Chona Simsuango arrived later in the visit. The facility's license shows a capacity of six (6) non-ambulatory residents, two (2) of which may be bedridden. The facility is additionally approved for two (2) hospice residents. During today’s inspection there were five (5) residents in care, but four (4) were out at program.

LPA, Caregiver Pascua, and Administrator Simsuango 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, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to clients were all compliant: Common resident bathroom sink read at 106F. 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.

Kitchen area was clean and organized. The facility contained at least two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. Knives were locked and inaccessible to residents.