Facility Evaluation Report

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Staff S1,Nida Reguindin. During the visit, LPA observed 2 residents and 2 staff. LPA explained the purpose of the visit.

Staff S1 contacted ADM and informed her that LPA had arrived to conduct an annual inspection. ADM informed LPA that the staff files and residents P&I records were with her. ADM stated she won't would be able to arrive to the facility, so LPA can review residents P&I records and staff files.

LPA toured the facility inside out with S1 which included the Living room, kitchen, dining room, 2 restrooms and 3 residents bedrooms. The staff area of the facility was also inspected. LPA also toured the facility garage, which is being used as a storage place/ Laundry area. The front yard and backyard were inspected. There was no obstruction to block the walkways.

While touring resident bedroom #1, LPA observed the wall directly next to a residents bed, closest to the door, leading outside. LPA observed the wall directly next to the bed had its paint peeled off, revealing the drywall. S1 stated resident R1 has a behavior of peeling the paint from the wall. (Photographs were taken.) S1 stated R1 has been peeling the paint since he/she moved into the home.

Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 74 degrees F, and hot water temperature ranged from 107-109 degrees F in both resident bathrooms.