Facility Evaluation Report

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced to conduct an Annual Required 1 Year inspection and met with care staff, Mark Sambayan and Mark Padilla. Mylene Copero, co licensee and Administrator arrived few minutes later. This facility is licensed for 6 Non-ambulatory residents with a Hospice Waiver approved for 1 of the residents and no Bedridden approval.

LPA initiated a tour of the facility and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Residents rooms were furnished per regulation. Water temperature in bathrooms used by residents measured at 115 degrees F which is within the required range of 105 to 120 degrees F allowed per regulation. Extra hygiene products and linens were available. Closet containing cleaning supplies was locked. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality and stored per regulation. Medications were centrally stored and locked. Facility maintains emergency food and water supplies.

Fire extinguishers were fully charged and last serviced February 9, 2023. Smoke and Carbon Monoxide detectors located throughout the facility were tested and operational. Most recent disaster drill was conducted 8/10/2023.

Staff have required First Aid and CPR certificates that expire in 2024. Certificate for Administrator, Johnny "Juanito" Copero, 6017113740, expires on 6/11/2024. Training records were reviewed. Required postings were observed. Medication records were reviewed.