Facility Evaluation Report

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct a 1 year required/annual visit. LPA Lund met with Care Staff Myrina Cabico and explained the reason for the visit. Care Staff Myrina Cabico called Administrator Claire Rabang who could not make the visit today and gave permission for Care Staff Myrina Cabico to sign required paperwork. Census: 3

LPA Lund & Care Staff Myrina Cabico tour/inspected the facility. LPA inspected the dining area, living area, and all other areas intended for resident use. LPA observed to be furnished and maintained in compliance at this time. The Facility had a Medication cabinet (locked) and stored. First aid kit was observed in the Medication cabinet to be present and contained all required components at this time. LPA inspected four (4) residents bedrooms, with two shared & two individual rooms. Furnishings for residents were observed to meet the needs of the residents at this time. The facility also had two bathrooms for the residents. One bathroom is in a room for one individual. The facility has one room for staff use with a bathroom. The exterior grounds was conducted. A review of the facility perimeter fence, side gates, and walkways were observed to be maintained in compliance at this time. The facility has one fire extinguisher (11/7/2025) that and carbon monoxide are in compliance. The facility has a working telephone. The facility has 7-day non-perishable and 2-day perishable foods. LPA Lund reviewed 2 resident files and two staff files and were in compliance at this time.

No deficiencies cited on this visit and report left.