Facility Evaluation Report

Licensing Program Analyst (LPA) conducted an unannounced annual inspection today and met with administrator (ADM) Carlito Ocampo. Upon arrival, staff Crisanto Garcia (CG) took LPA's body temperature, and checked LPA in guest log book. LPA observed COVID posters in the facility. LPA observed the screening station at the main entrance.

LPA toured the facility inside out with CG. Living room, family room, dinning area, laundry room, kitchen and restrooms were inspected. All the trash cans are with covers. LPA observed 3 staff and 2 residents in facility. The other 3 residents were out for day program. Medication closet, knives closet, and cleaning product closet were observed locked. There are 3 resident shared rooms and one staff live in room. The beds in shared rooms were observed 6 feet apart. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. There was no posters of washing hands for 20 seconds in the restrooms and in kitchen. ADM stated the facility will put the posters of washing hands for 20 seconds in restrooms and kitchen in 3 days.

Fire extinguisher was observed serviced on 04/25/2022. Smoke dictators were tested and were working fine. Room temperature was observed at 74 degree F. Hot water temperature was observed at 110 degree F. Front yard and back yard were inspected. No obstruction was observed to block the walkway.

ADM stated all the residents and staff are fully vaccinated and done with boosters. The facility already submitted the Infection Control Plan to LPA.

No citation was noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of this report was emailed to ADM.