Routine inspection·July 27, 2021

Licensing Program Analyst (LPA) Daniel Pena visited the facility to conduct an annual required licensing inspection. LPA was met by Caregiver, Merlita Simeon and was granted entry into the facility and discussed the purpose of the visit. Administrator, Jesusa Pascua, later met with LPA to review the facility's Plan for Epidemic Outbreak Specific to COVID-19 Mitigation Plan Report and protocols. During today's visit, LPA toured the facility, and verified compliance with infection control practices. LPA and Caregiver Simeon reviewed the facility’s COVID-19 Mitigation Plan Report and staff practices. LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff, residents and visitors; a sign-in policy enacted for all visitors; signs posted at facility entrance with the facility’s visitor policy and signs throughout the facility to promote hand hygiene, cough/sneeze etiquette and physical distancing; face coverings worn by staff; hand sanitizer/hand washing stations readily available; a designated visitation area; emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of cleaning products and PPE. No deficiencies were cited during today’s visit. An exit interview was conducted with Administrator Pascua and a copy of this report, along with the Licensee Rights (LIC 9058 FAS 01/16) were provided to Ms. Pascua via email. An electronic receipt of confirmation was requested to be sent by the Administrator upon receipt of the documents.