Facility Evaluation Report

On February 24, 2026, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregivers, Ruben Cabrera and Elizabeth Princesa and LPA explained the purpose of the visit. Administrators, Marie and Chris Cayabyab and Administrator Designee Ninfa Gozon arrived and assisted with the inspection.

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

LPA observed 5 resident rooms (4 private and 1 shared rooms) and 1 staff room. Rooms were spacious and included all required furnishings. Bathroom was observed equipped with paper towels, soap, grab bars, and non-skid mats. Hot water temperature in the kitchen, and bathroom was measured at 105- 118 degree F. Extra linen was present. Medications, toxins and sharps were observed to be locked. 2 days for perishables and & 7 days non-perishable were observed to be present.

Facility is equipped with smoke detectors and carbon monoxide detectors. Fire extinguisher were last serviced in 9/9/2025. Fire drill records were reviewed.

A review of (6) resident files was conducted and noted on the LIC 858.

A review of (2) staff files was conducted and noted on the LIC 859.

LPA reviewed P& I/ Case Resource Records for 4 residents to be adequate.