Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an annually inspection and met with Staff Lead .Senen Semana (SS)..

Upon arrival at the facility main entrance, staff Emerencian Rabara (ER) took LPA's body temperature, asked LPA the infection control questionnaires, and checked LPA in the visitor log book.

LPA toured the facility with SS. There are 3 resident rooms in the facility. LPA observed 4 residents (R1 - R4) in the bedrooms, living room, and family room. LPA observed another staff Jhed Paguio (JP) in facility. COVID-19 posters were observed at the facility. LPA observed the staff wore the masks.

LPA inspected the facility food supplies. The two day perishable food and seven day nonperishable foods are sufficient. LPA observed hand sanitizer were at many places in the facility. LPA observed not all the trash bins in the facility are with covers. SS stated the facility will change all the trash cans to be with covers. LPA observed the beds in one bedroom is not 6 feet apart. SS stated the facility will make the beds 6 feet apart. SS stated all the staff and residents are fully vaccinated.

No citation were issued during today's inspection. Exit interview conducted with SS. This report was provided to SS to review and to sign. A copy of this report was emailed to SS.