Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) JHANELLE GUICO . Upon arrival, Staff Emeely Castilio (S1) took LPA body temperature, and checked LPA in the visitor log book.

LPA toured the facility inside and out with ADM. COVID posters were observed at main entrance and the facility. Screening station with masks, hand sanitizer, thermometer and visitor log book was observed at the main entrance. Living room, family room, kitchen, dinning room and three restrooms were inspected. Trash cans were observed with covers. Paper towels were observed with holders. Posters of washing hands for 20 seconds were observed by the sinks in kitchen and restrooms. Three resident bedrooms, and laundry room were inspected. The beds in the shared rooms were observed 6 feet apart. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. PPE supplies were observed sufficient. Medication closet, knives closet, and cleaning product closet were observed locked. Room temperature was at 70 degree F, and hot water temperature was at 105 degree F in facility. Two staff live-in rooms were observed in the facility. Two residents and two staff were observed in facility.

Fire extinguisher was serviced on 6/29/2022. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways.

ADM stated all the residents and staff are fully vaccinated and done with boosters. ADM stated the facility already submitted the Infection Control Plan to CCL office. No citation were noted today. Exit interview was conducted with ADM. This report was provided to ADM