Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 12:46PM. LPA met with Licensee/Administrator Edna Dangiapo. Entrance interview conducted.

Beginning at 12:48PM, the LPA, along with Licensee/Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed:

Smoke detector was tested at 02:45PM and carbon monoxide detector was tested at 02:45PM and both were functional at the time of the visit. Fire extinguisher was observed to be fully charged and last serviced on 03/16/2023.

BEDROOMS: There are 6 (six) total bedrooms; 1 (one) of which is a shared resident room, 4 (four) are private resident rooms and 1 (one) is designated as a staff room. The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Staff room was observed to be locked.

RESTROOMS: The LPA observed 2 (two) restrooms in the facility, both of which are common restrooms for shared resident use. Resident restrooms were observed to be clean and sanitary and in operating condition with grab bars and non-skid surfaces. Water temperature was measured and was within the required range.

KITCHEN : Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food.

Adjacent to the kitchen is a garage. Garage remains unlocked, but contains a locked cabinet that contains cleaning supplies, personal grooming items, as well as knives and sharps. Garage also contains extra food, emergency food and water as well as storage.