Routine inspection·October 24, 2022

Licensing Program Analyst (LPA) Jenifer Tirre made an unannounced visit on this day for the purpose of conducting an annual inspection. LPA was greeted and allowed entry. Facility has hand sanitizer, visitor sign in station. LPA's Temperature checked upon arrival. Licensee Jay Parungao joined LPA shortly after. LPA Toured the interior and exterior of facility. Facility is a 6 bedroom (5 resident rooms, 1 staff) and 3 bathroom single story home. There are 5 Residents in care. LPA observed proper covid signage in entry way of facility. Facility has required Department postings. LPA observed copy of Administrators Certificate expiring 8/15/24. Required department documents such as Emergency Disaster Plan and Mitigation Plan are posted at facility. LPA toured all Residents rooms, all rooms had required furnishings such as bed, chair, dresser and night stand. Resident rooms where within regulations. All restrooms observed contained working wash basin, soap, toilet paper and paper towels. Restrooms had proper hand washing signs. LPA observed several visitation areas with ample seating. Residents were observed relaxing in the Living room and bedrooms watching TV. Facility has audible alarm system and operating smoke and carbon monoxide detectors. Facility has 1 fire extinguisher fully charged. Facility has 2 days perishables and 7 days non perishable food supply. Facility has ample emergency food and water supply. Facility has a secured location for resident medication and files. LPA observed 5 of 5 resident files. Residents emergency contact information and Physicians reports are current. LPA observed residents medications and facility has 30 days supply of medications for Residents. LPA observed staff following Covid 19 infection control protocol wearing face masks. No deficiencies noted during todays visit. An exit interview was conducted with Licensee Jay Parungao and a copy of this report was left at facility.