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25 | Licensing Program Analyst (LPA) M. Flores arrived at the facility unannounced to conduct a required annual visit. LPA explained the purpose of the visit and was granted entry by Licensee, Marilen Gonzales. The Licensee left the facility minutes after and approved staff, Constancia Dampitan to complete this annual visit.
The residence was set at 73 degrees F temperature and free of passageway obstructions inside and outside. LPAs observed five bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured at 118.6 degrees F.
Kitchen toured, supply of food observed, and food stored properly for perishable and nonperishable. Medication and knives are locked next to the kitchen area. Cleaning supplies were locked in the hallway closet. Smoke detectors and carbon monoxide are dual detectors, they were checked and operating. Fire extinguisher was charged and was serviced on 02/06/2023. Emergency disaster drills are conducted quarterly, last drill completed on 12/10/2023. First Aid kit is fully equipped.
There was outdoor seating for the residents. Outdoor area was clean and free of obstruction.
An exit interview was conducted and a copy of this report was provided to staff, Constancia Dampitan whose signature confirms receipt. No deficiencies cited.
LPA requested the following updated forms faxed to CCLD by 12/30/23: Designation of Facility Responsibility (LIC308), Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage and Administrator’s certificate. |