Facility Evaluation Report

Licensing Program Analyst (LPA) Marcella Tarin conducted an unannounced annual inspection and met with Administrator (ADM) Vivencio Ignacio. LPA stated the purpose of the visit. ADM stated the facility has 4 residents. LPA observed 4 residents and 2 staff.

LPA toured the interior and exterior of the facility with ADM to include the kitchen, resident rooms, dining room, bathrooms, back and front of the facility. All exit and passageways were free and clear of obstruction.

LPA toured the kitchen area and observed a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed the refrigerator temperature at 37 degrees F and Freezer at -6 degrees F.

LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care.

The facility was equipped with smoke and carbon monoxide detectors. All smoke detectors functioned properly when tested by ADM. Fire extinguishers were last serviced on 6/24/2024. LPA reviewed the facility first aid kit, and it was observed to be complete. The facility emergency drill log was reviewed. The facility's last drill was on 12/2/2024. ADM stated the facility will conduct a drill by 5/30/2025.

LPA toured 6 resident bedrooms. All 6 resident rooms have a bed, functioning lights, dresser/table, bedding and space for personal belongings.