Facility Evaluation Report

On April 8, 2026, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregiver, Jannette Sumampong. LPA explained the purpose of the visit. The administrator, Gianne Vizconde arrived during the inspection.

LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. LPA toured inside and outside including all of resident rooms, common areas, and kitchen area. The indoor and outdoor passageways were free of obstruction. Comfortable temperature is maintained and lighting is sufficient for comfort.

During the tour of the facility, LPA observed the facility layout did not match the facility sketch. The caregiver stated that the facility made some changes to the room assignment, room #5 was a staff room and is it now being used as a resident's room and room #4 used to be a resident room and it is now being used as staff room. The administrator was advised to update the facility sketch, submit it to CCL by 4/20/2026 and LPA will proceed with necessary steps to complete the change in facility sketch process.

LPA observed 5 resident rooms and 1 staff room. Rooms were spacious and included all required furnishings. Bathrooms/Shower rooms were observed to be clean; equipped with paper towels, soap, and grab bars, and non- slip resistant mat. Hot water temperature in the kitchen, and bathroom was measured at 107- 110 degrees F. 2 days for perishables and & 7 days non-perishable were observed to be present.