Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Dolores arrived announced to conduct the facility's pre-licensing inspection. LPA met with Licensee, John Manibusan and future Administrator, Avery Manibusan.

The facility has an approved fire clearance for 4 ambulatory residents. The facility has at least 2 fire extinguishers, smoke detectors, and carbon monoxides present in the facility. All exit areas were free and clear of obstruction.

The facility has a total of 4 private resident bedrooms each equipped with a bed, linens, dresser, night stand, lamp, ceiling light, closet, and a chair. The facility has 2 bathrooms each equipped with a toilet, shower, sink, garbage can, and lighting. The showers contains non-slid matts and grab bars. Bathroom hot water temperature located in the hallway is maintained at 118 degrees Fahrenheit.

The kitchen is equipped with plates, cups, bowls, utensils, and a lidded trash bin. LPA observed a drawer that contains a lock that is intended to store sharp objects. Chemicals and disinfectants observed stored in a locked cabinet located in the garage. Licensee was advised to ensure a lock will be placed if they plan to store chemicals and disinfectants underneath the kitchen sink. Licensee stated understanding. Kitchen refrigerator and freezer did not contain a thermometer. Licensee purchased a thermometer during visit. LPA advised the kitchen refrigerator should maintain a maximum temperature of 45 degrees Fahrenheit and freezer should maintain at 0 degrees Fahrenheit. LPA observed non-perishable foods in the cabinet. Facility has at least 7 days worth of non-perishables. SEE LIC809-C.