Facility Evaluation Report

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct an Annual Required Inspection and met with Administrator, Ernesto B Idang. Licensee Josephine Blancaflor arrived later. There are residents with a diagnosis of dementia and residents receiving hospice care services within approved hospice waiver.

LPA/Administrator initiated a tour of the facility and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in resident's bathroom measured at 109.8, 109.4 & 108.2 degrees F which was within allowable range of 105 to 120 degrees F. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Kitchen cabinet containing cleaning supplies was locked. Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored and locked. Fire extinguisher was last inspected April 2026. Facility has hardwired combination smoke/carbon monoxide detectors located throughout the facility that were tested and operational. Exit doors have auditory alert system that were functional at time of visit. Last disaster drill was conducted on 03/16/26. File review was initiated at 10:00am. Three staff files and five resident files were reviewed. Staff have required First Aid and CPR certificates. Training records reviewed. Residents' care plans and medical assessments are current and included a description of any known behavioral expression. Administrator Certificate for Ernesto B Idang 7031981740 expires 4/15/2027. Medications and medication records were reviewed.

Licensee submitted updates of the following documents: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500), lease agreement and copy of Liability Insurance.

No deficiencies cited during today's inspection. Exit interview conducted with Licensee and a copy of this report was given.