Facility Evaluation Report

On 6/23/2025, LPA Grace Donato made an unannounced annual visit to the facility. LPA met Care Staff Rowena Bonifacio. LPA explained the purpose of the visit.

LPA toured the facility inside and outside including resident rooms, common areas, kitchen area and garage. The indoor and outdoor passageways were free of obstruction. LPA observed some residents were in the dining area watching tv. Facility is single story house with 4 bedrooms, 2 of which are shared. A comfortable temperature of 70 deg F is maintained and lighting is sufficient for comfort. Hot water was also tested in the bathrooms and the temperature was 115 deg F. The residents have adequate number of linens and incontinence care items. All personal belongings are intact. Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current. Resident bedrooms and bathrooms were observed to be in good repair equipped with grab bars and non-skid mats. LPA checked the food supply and there is adequate amount of food, 2 days for perishables and & 7 days non-perishable. Emergency drills are logged and done every quarter. LPA observed sharps, toxins and chemicals to be locked and inaccessible to residents.

LPA reviewed 2 resident records and 2 staff records. Resident records are updated, complete and signed. Staff records are also complete. Facility accepts hospice residents and are in compliance with the required waiver requirements. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. P&I money was counted and complete.

No citations issued today, Report is reviewed and copy is provided.