Facility Evaluation Report

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

LPA observed 3 staff and 5 residents in the facility. LPA reviewed 3 client files and 2 staff files. License, personal rights posters were observed in the facility. Administrator certificate was observed expired. ADM showed his/her ADM certificate is in active list on the website.

LPA toured the facility inside out with ADM. Living room, family room, dinning room, laundry room, kitchen, garage, and restrooms were inspected. 1 staff room and 3 resident shared rooms were observed in the facility. Medication closet, knives closet, and Detergent closet were observed locked. 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 108 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. First aid box, flash lights were observed in the facility.

Fire extinguisher was observed serviced on 04/15/2024. The facility is equipped with smoke and carbon monoxide detectors. Smoke detectors 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 11/05/2024.

No citation 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.