Facility Evaluation Report

Licensing Program Analyst (LPA) conducted an unannounced annual inspection today and met with Administrator (ADM) Carlito Ocampo.

LPA observed 4 staff in the facility including administrator. LPA reviewed 5 client files and 5 staff files.

LPA toured the facility inside out with ADM. Living room, family room, dinning room, laundry room, kitchen and restrooms were inspected. There was no non skid pad in the shower area of the bathroom. 1 staff room and 3 resident shared rooms were observed in the facility. Medication closet, knives closet were observed locked. Detergent was observed unlocked by the sink in the kitchen. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Room temperature was at 70 degree F, and hot water temperature was at 106 degree F. The temperature of the refrigerator was measured at 40 degree F, and the temperature of the freezer was measured at 0 degree F. Two screens of windows were observed not in good repair.

Fire extinguisher was observed serviced on 04/12/2023. The facility is equipped with smoke and carbon monoxide detectors. Smoke dictators were tested and were working fine. Front yard and back yard were inspected. No obstruction was observed to block the walkway.

LPA reviewed the facility records, it shows the facility had emergency and fire drill on 11/02/2023. Three caregivers' first aid training certificate were observed expired.

Deficiencies were 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.