Facility Evaluation Report

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator Philomena Agbontaen. During the visit, LPA observed 6 residents and 2 staff. LPA explained the purpose of the visit.

LPA toured the facility inside out with ADM which included the Living room, kitchen, dining room, 3 restrooms and 6 residents bedrooms. There was no obstruction to block the walkways. The staff area of the facility was also inspected. The front yard and backyard were inspected.

while touring the facility kitchen with ADM, LPA observed there was no staff or residents in kitchen. LPA observed an unsecured half orange tablet on the kitchen table. S1 stated the half tablet belonged to resident R4. S1 stated there is a hold parameters for medication M1, based on the blood pressure. ADM stated R4's blood pressure was too low and the medication was on hold. S1 stated he/she had forgotten to put the medication tablet back.

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 75 degrees F, and hot water temperature was measured at 112 degrees F in resident bathrooms.