Facility Evaluation Report

Licensing Program Analysts (LPAs) Charlie Yang and Arielle Pascua conducted an unannounced Annual/Infection Control visit on 05/12/2022. LPAs met with Facility Designed Administrator, Remy Raqueno. Her administrator license expires on 12/26/2023. Two staff members were present, Maria Gudoy and Benilda Natividad. Census was currently at full capacity with 6 residents.

The interior of the physical plant was in good condition and sanitary. Fire extinguishers appeared to have been annually inspected and was valid until 10/29/2022.

The kitchen area was toured. LPAs observed a sufficient seven days of non-perishable foods as well as two days worth of perishable food supplies in the main kitchen. Soap and cleaning supplies under the sink were locked. Additional non-perishable food supplies were identified in the garage.

LPAs observed a locked centralized stored medication cabinet. Along with the administrator, the LPAs observed, reviewed, and compared resident medication and medication dispensing logs. First Aid Kit was present and contained all of the required components.

A tour of the bathrooms was conducted. No soap or cleaning supplies were stored under the sinks. Hot water temperature was within the required range of 105-120 degrees. All Linen closets located in the hallways presented a sufficient amount of linen to supply for resident bedding.

A tour of the bedrooms was conducted. Resident furniture was observed to be sufficient to meet their needs at this time.

Laundry area was toured. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time.

Common areas were toured. Living room, dining area and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time.