Facility Evaluation Report

On July 11, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual visit. LPA met with Administrator, Amy Sorongon and explained the purpose of the visit.

LPA toured the facility inside and outside including all of resident rooms, common areas & kitchen. The indoor and outdoor passageway was free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a single story facility. There are four resident rooms, all of which are single private rooms. Resident rooms were observed to be clean with all required furniture. No residents were present during the visit as the residents were at their day programs. LPA observed one full bathroom and one half bathroom. Both bathrooms were observed clean and odor-free, equipped with liquid soap and paper-towels. Water temperature throughout the facility measured between 115-118 degrees F. Extra linen was observed to be present. First aid kit was observed to be complete.

Dining room was observed free from tripping hazards. A comfortable temperature is maintained and lighting is sufficient for comfort. LPA observed two day perishables and seven day non-perishables. Extra food supply was observed to be present. Medications, sharps, and chemicals were observed locked an inaccessible to residents in care.

Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of

May 2025. Emergency drills are logged and done every three month. LPA reviewed 4 resident records and 5 staff records. Resident records are updated, complete and signed. Staff records are complete, with training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated.

No citations are issued during the visit. Report is reviewed with Administrator, Amy Sorongon and a copy is