Facility Evaluation Report

On April 16, 2025, at 08:40 AM, the Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. The LPA met with the Assistant Administrator (ADM), Ofelia Guanzon, and disclosed the purpose of the inspection. ADM informed the LPA that the facility had (5) residents in care and (2) staff members present at the time.

At 9:06 AM, the LPA initiated a walk-through of the facility, accompanied by the ADM.

LPA inspected the kitchen and found it clean, with no food preparation and cooking in progress at the time. The appliances were checked and observed to be in working order. The LPA inspected a locked cabinet containing knives and sharp objects, and a locked cabinet under the sink with detergents and cleaning supplies. The refrigerator and pantry cabinets were inspected, and sufficient supplies of fresh perishable food for (2) days and nonperishable staples for (7) days were observed. No expired food or stored medications were noted.

LPA inspected the living room and observed it clean, with all furniture in good repair. There were sofa chairs, recliners, tables, a wall mounted television, a covered fireplace, and a piano in the living room.

LPA inspected the dining area adjacent to the living room and found it clean. The dining table and chairs were observed to accommodate the residents, and all the furniture was in good repair. Two (2) residents were observed eating breakfast.

LPA inspected the fire extinguisher mounted on the wall in the kitchen and found it fully charged, with the last service tag dated 04/30/2024. The ADM tested the smoke and carbon monoxide detector located in the living room in the LPA's presence, and it was found to be functional. Additional smoke and carbon monoxide detectors were observed in all bedrooms and common areas of the facility during the visit.