Facility Evaluation Report

On 1/18/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA was greeted by Staff Member (SM), Dori De Guzman and asked that she callthe Facility Designated Representative (FDR), Necita Abellas that CCL was present. Shortly after, LPA met with FDR Abellas and explained the purpose of the visit. The purpose of this visit was to conduct an annual visit.

Current census 6. This facility is licensed to serve 4 nonambulatory residents, 1 ambulatory residents and 1 bedridden. 1 Non-ambulatory resident must be in room 4 with a direct exit. This facility is also vendorized to accept and retain Level 4I residents at this time.

A brief interview with FDR Abellas. FDA Festus has a current Administrator Certificate #7002430735 and expires on 12/08/2026. LPA discussed the following items that are required for Administrator change.

A review of 3 resident files and 3 staff files were conducted. Both staff and resident files were complete and up to date.

A tour of the facility was conducted. Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational.

A tour of the living area, dining area, and other areas intended for resident use was conducted. Furniture and furnishings were observed to be in good repair.

A tour of the kitchen was toured. LPA observed 2 day perishable and 7 day non-perishable food supply to meet the needs of the residents. Knives were observed to be locked and made accessible.

A tour of the laundry room was conducted. Laundry supplies such as detergent and toxins were observed to the made inaccessible.

A tour of the garage was conducted. Refrigerator was observed to hold additional perishable food supplies.

A tour of the backyard was conducted. Perimeter fence and gates were observed to be in good repair.

A tour of 2 resident bathrooms were conducted. Hot water temperature was taken to ensure it was within 105-120 degrees.

A tour of 4 resident bedrooms were conducted. Each bedroom housed 2 residents. Furniture and furnishings were observed to be in good repair. A linen closet was observed and had sufficient supply.