Facility Evaluation Report

Licensing Program Analyst (LPA) Rankin arrived at 11:25 am to conduct a 1 year annual visit to the facility above. LPA met with Administrator Amelita Antonio and Juanito Pasion and explained the purpose of the visit.

A tour of the inside and outside of the facility was conducted. The following was inspected and noted during the annual visit:

Physical Plant & Environment Safety: The fire extinguisher was last charged and inspected on 01/13/25. The facility has 4 resident bedrooms and 2 bathrooms currently occupying 5 residents. LPA was authorized to enter and inspect facility. The facility has smoke and carbon monoxide detectors. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The showers have non-skid mats/flooring. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. Disinfectant and cleaning solutions are inaccessible to residents in care and locked in laundry room cupboards. The facility has sufficient space inside and outside for activities and visiting. The facility has a fenced backyard for client use with plenty of shade. The facility has telephone and internet service for resident use.

Operational Requirements: The Facility is operating in compliance with the granted fire clearance. The facility has current liability insurance and expires on 01/30/26. The facility is approved for a capacity of 6. The fire clearance is granted for 6 Non-Ambulatory of which 2 may be bedridden. Hospice is approved for 4.

Staffing: The facility currently employs 3 full time and 1 Administrators and has additional on call staff if needed. Staff records are kept confidential. Files reviewed had current 1st Aid, Personnel Records/Application, Health screening with TB results, Criminal Record statements, and Fingerprint clearance/Associations/exemptions. Current Administrator Certificate will expire 08/02/25.