Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with House Manager (HM) Marites Fernandez. Upon arrival, Staff Ricardo Clutario (S1) took LPA body temperature, and checked LPA into the visitor log book.

LPA toured the facility inside and out with HM. COVID posters were observed at main entrance and the facility. Screening station with masks, hand sanitizer, thermometer and visitor log book was observed at the main entrance. Living room, kitchen, dinning room and three restrooms were inspected. Trash cans were observed with covers. Paper towels were observed with holders. Cloth towels were observed in kitchen and in restrooms. Posters of washing hands were observed in restrooms. Posters of washing hands for 20 seconds were not observed by the sinks in kitchen and restrooms. HM stated the facility will put the posters of washing hands for 20 seconds in restrooms and kitchen in 3 days. Three shared resident bedrooms, one staff live-in room and laundry room were inspected. The beds in shared rooms were observed 6 feet apart. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. PPE supplies were observed sufficient. Medication closet, knives closet, and cleaning product closet were observed locked. Cleaning products were also observed in the closet under the sink in kitchen, HM stated the facility will add a new lock for the closet under the sink in kitchen in 3 days. Room temperature was at 70 degree F, and hot water temperature was at 107 degree F in facility. 6 residents and 2 staff were observed in facility.

Fire extinguisher was serviced on 8/13/2022. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by HM, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways.

HM stated all the residents and staff are fully vaccinated and done with boosters. HM stated the facility already submitted the Infection Control Plan to CCL office. No citation were noted today. Exit interview was conducted with HM. This report was provided to HM