Facility Evaluation Report

Licensing Program Analysts (LPAs) Simi Rai and Mita Partoza conducted an unannounced Required 1 Year visit and met with Administrator, Angelita Bernardo. Upon entering the facility, LPAs observed volunteer (V1) at the facility with 4 residents inside the facility. LPAs spoke to the Licensee/Administrator over the phone to inform of the visit and Licensee/Administrator came to the facility afterwards.

During visit, LPAs toured the inside and outside of the facility. When touring the outside area of the facility, the one out of two exits were cleared of obstruction. The fence on the left side of the facility facing the street was obstructed by the blue recycling bin and the exit door was only able to open approximately 1 foot. LPAs observed 3 Lysol wipe cans near the door leading towards the backyard. LPAs observed unlocked chemicals in open cabinet on top of the laundry machine, which included but not limited to Clorox solution, laundry detergent and Windex cleaning solution.

LPAs toured the facility living room and observed a knife on the table, accessible to the residents in the facility. LPAs observed the volunteer not in the room and not utilizing the knife at the time of inspection. LPAs observed a paper bag containing resident medication in the living room, which was not locked and accessible to the residents at the facility.

LPAs observed a knife in the kitchen sink, where the kitchen was not being utilized for food prep at the time of inspection. LPAs toured the kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food.