Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with House Manger (HM) Tyrino Malig.

LPA toured the facility inside and out with HM. 3 staff and 3 residents were observed in the facility.

LPA reviewed 3 resident files and 3 staff files.

Licensee, Administrator Certificate and personal right posters were observed in the facility. Living room, office, kitchen, dinning room, and two restrooms were inspected. Three single resident bedrooms, and laundry room were inspected. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet, knives closet, and cleaning product closet were observed locked. Room temperature was at 73 degree F, and hot water temperature was at 110 degree F in facility. The temperature of the refrigerator was at 37 degree F, and the temperature of the freezer was at 0 degree F. Flash lights and first aid box were observed in the facility.

Fire extinguisher was serviced on 06/22/2023. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors were tested by staff. The smoke detectors were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways.

The last time the facility conducted the emergency and fire drill is 2/5/2024.

Deficiencies were noted today. See LIC809-D. Exit interview was conducted with HM. This report was provided to HM for signature. A copy of the report was provided to HM.