Facility Evaluation Report
On 10/17/2022 at 10:15am, Licensing Program Analyst (LPA) Arielle Pascua arrived at this facility unannounced to conduct an annual infection control visit. LPA Pascua was greeted by staff member, Michael Gamboa and was asked to call the Administrator, Maybelyn Magsayo-Ugale to let her know that licensing was present at this time. Upon arrival the LPA observed a centralized screening point equipped with hand sanitizer and masks. Shortly after, LPA Pascua met with Administrator Ugale explained the purpose of the visit. The purpose of the visit is to conduct an annual infection control visit. This facility is licensed for 6 non-ambulatory residents and has a hospice waiver for 2. The administrator has an active certificate #6026752740 and expires on 09/17/2023. There were 4 other staff members present at this time, Michael Gamboa. Theresita Alvarez, Nora Casaverde, and Rosita Curilan.
At 10:30am, LPA Pascua initiated a tour with Administrator Ugale.
At 10:35am, LPA Pascua toured the laundry room and garage. Washer and Dryer were observed to be in good repair. A linen closet was identified in the garage and was observed to be a sufficient amount of linens for 6 residents at this time. LPA observed toxins, laundry detergent and other supplies to be in locked cabinets located in the garage and made inaccessible to the residents in care.
At 10:45am, LPA Pascua toured the kitchen. LPA observed there to be a sufficient amount of 2-day perishable and 7-day non-perishable food supply. Kitchen cabinets, appliances, and sink were observed to be in good repair. LPA observed knives to be located in a closet located in the hallway next to the kitchen. A fire extinguisher located in the kitchen was observed to be serviced by a local fire company, Armor Fire Co. on 06/28/2022.
At 10:50am, LPA Pascua toured the dining room and living room. Windows, blinds, and screens were in good repair. Furniture and furnishings intended for resident use were observed to be in maintained and in good repair.
At 10:55am-11:10am, LPA Pascua toured 3 shared resident bedrooms. Resident furniture was observed to be sufficient to meet their needs at this time.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction