Routine inspection·September 29, 2025

At approximately 12:25 PM, Licensing Program Analyst (LPA) Elias Magdaleno arrived unannounced to conduct a required 1-year annual inspection and was greeted by Administrator Jolly Carungcong. Facility is a Residential Care Facility for the Elderly (RCFE) with twenty-two (22) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for eight (8), with four (4) Hospice residents currently in care, and is approved for all non-ambulatory residents, six (6) of which may be bedridden. At approximately 12:30 PM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one (1) story home, was a comfortable temperature, and passageways were free from obstructions. Fire extinguishers were last inspected 4/25. Smoke and Carbon Monoxide detectors are hardwired and last inspected by third party vendor on 5/25. Water temperatures measured 115.7-, 113.7-, and 115.1 degrees F in a spot check of resident accessible sinks, which is within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, hygiene, incontinent care, and paper products available for residents. LPA conducted a spot check of resident bedrooms and observed them to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. LPA observed at least a two (2) day supply of perishable and seven (7) day supply of non-perishable food, as well as an emergency water supply. Food was found to be stored in a safe manner with open items covered. There is a shaded seating area in the backyard with outdoor space for activities. Delayed egress doors in back patio were tested and found operational. Facility has an internet access device and internet available to residents in care, and the phone was observed operational during today's inspection. Continued LIC809C... Continued from LIC809... Facility conducts twice yearly disaster drills, and the most recent drill was conducted 5/25. Facility was advised to conduct quarterly disaster drills to maintain compliance. LPA reviewed facility's emergency disaster plan which was last updated 7/25. LPA observed a supply of PPE, emergency supplies, a first aid kit, and flashlights. At approximately 1:40 PM LPA conducted a review of five (5) resident records. All required documentation present. Jolly Carungcong Administrator Certificate 7027194740 expires 1/6/2026. All fees are current as of this time. Updated copies of the following documents were gathered during this visit : Liability Insurance LIC500 - Personnel Report LIC308 - Designation of Responsibility LIC610E - Emergency Disaster Plan The annual inspection will be completed by the Department at a later date. No deficiencies cited. Exit interview conducted with Administrator, whose signature on form confirms receipt.