Facility Evaluation Report

On 11/2/2023, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct an annual visit. LPA met with Facility Designated Administrator (FDA), Christine Quiruz and explained the purpose of the visit. There was one other staff member was present at this time, Reginald Sanpablo.

This facility is licensed to served and accept up to 4 residents who are deemed to be ambulatory only. This facility is also vendorized to accept and retain Level 4I residents at this time.

Census was 3. 3 out 3 residents were out their respective day program.

LPA reviewed 6 staff files and 3 residents files. All of which were current and up to date. The administrator has a current administrator certificate #6022150735 and expires on 11/06/2024.

The interior of the physical plant was in good condition and sanitary. Fire extinguishers appeared to have been annually inspected by Armor Fire Extinguisher Company 03/19/2023.

The kitchen area was toured. LPA observed a sufficient seven days of non-perishable foods as well as two days worth of perishable food supplies in the main kitchen. Additional perishable food was identified in the additional freezer in the garage.

Dining areas, living areas, and all other areas intended for resident use were toured. It was observed that furniture and furnishings were sufficient and able to meet the needs of the residents at this time.

A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees.

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

LPA Pascua observed a locked centralized stored medication located in the hallway. Along with Administrator, the LPA observed, reviewed, and compared resident medication with the medication dispensing logs. First Aid Kit was present and contained all of the required components.