Facility Evaluation Report

On May 12, 2025, at 11:20 AM, the Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. The LPA met with the caregiver, Jesley Quirimit, and disclosed the purpose of the inspection. The caregiver informed the LPA that the facility had (6) residents in care and (2) staff members present at the time.

At 11:34 AM, the LPA initiated a walk-through of the facility, accompanied by the caregiver.

LPA inspected the kitchen and found it clean, with lunch food preparation and cooking in progress at the time. The appliances were checked and observed to be in working order. The LPA inspected a locked cabinet containing knives and sharp objects, and a locked cabinet under the sink with detergents and cleaning supplies. The refrigerator and pantry cabinets were inspected, and sufficient supplies of fresh perishable food for (2) days and nonperishable staples for (7) days were observed. No expired food or stored medications were noted.

LPA inspected the dining area adjacent to the kitchen and found it clean. The dining table and chairs were observed to accommodate the residents, and all the furniture was in good repair.

LPA inspected the family room and observed it clean, with all furniture in good repair. There were sofa sets, chairs, recliners, tables, and a television in the living room. One (1) resident was observed sitting on the recliners watching the television.

There were (5) bedrooms and (3) bathrooms designated for residents' use. One (1) resident room was shared occupancy and other four (4) resident rooms were single occupancy.