Facility Evaluation Report

Unannounced Annual visit made out to this facility on 01/29/2026 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility caregivers, Kherjee Reyes and Zenaida Pranada, who were briefly interviewed at this time. This LPA requested that they go ahead and contact the facility designated Administrator, Joyce Mabunga, to inform her that CCL was present at this time. The back up Administrator, Pedro Pancho, arrived shortly thereafter to this facility.

Current census was 5 residents. It was learned that there was (1) resident under the care of hospice at this time. This facility does have an approved waiver to be able to accept and retain up to (2) residents under the care of hospice at any given time.

It was learned that this facility has a program to be able to accept and retain dementia residents at any given time. It was learned that there was (1) resident diagnosed with dementia at this time. It was learned that there was (1) resident receiving services through home health at this time. It was learned that this resident also had a bedridden resident in care at this time. The master bedroom was fire cleared to be able to accept and retain up to (1) resident deemed to be bedridden at any given time.

Dining area, living area, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time.

Linen closet, located in facility hallway closet, was reviewed and observed to contain a sufficient supply of towels, sheets, and bedding able to meet the needs of the residents at this time.

Kitchen drawers and cabinets were opened and reviewed.

Food supply for 2-day perishable and 7-day nonperishable quantities was reviewed to make sure that they were in compliance at all times. Pantry area was toured.