Routine inspection·April 13, 2026

Licensing Program Analyst’s (LPAs) Carmen Lopez and Eryn Kane, conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA’s identified themselves and were granted entry by caregiver’s Emelinda and Joseph Pagulayan. LPAs discussed the purpose of the visit with licensee/administrator Eunice Ambal who later arrived and joined the visit. According to the facility’s license, there may be a maximum of 6 residents, all of whom may be non-ambulatory, and is approved for one bedridden resident in bedroom #2, in at any given time at the facility site. The facility is approved for 3 hospice residents. During today’s inspection, the facility’s current census is 6 residents living at the facility. There were 6 residents present at the facility site during the inspection. LPAs inspected the interior and exterior of the facility and inspected each room. The facility was clean, sanitary and in good repair. Pathways were free of obstruction and slip hazards. Resident’s bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and activities. The facility’s ambient internal temperature was comfortable and compliant, at 71º Fahrenheit (F). Hot water temperature at taps accessible to residents were also compliant. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] There were at least 2 days of perishable food, and at least 7 days of non-perishable food present. Cooking, dining equipment and utensils were present, and all stored, but there was a sharp object that was out during the inspection. There were no toxic chemicals or poisons accessible to residents. Medications were properly labeled, as required, and stored in locked cabinet, which LPA inspected. The facility-maintained medication logs, which LPA reviewed. There were medication inconsistencies which LPA reviewed with the Administrator. No pools or bodies of water on the premises. Per administrator Eunice Ambal, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and the facility telephone were all working. Fire extinguishers were present (01) and serviced within the last 12 months. The first aid kit was complete and readily accessible. LPA spoke with residents and staff, and reviewed staff and resident records. LPAs visit did not raise licensing concerns. The files that LPA reviewed contained the required documents. Confidential records were stored in a locked cabinet. Required licensing postings were observed in a visible area of the facility. There were deficiencies observed and cited during today's annual inspection, which may be found in the LIC809-D pages of this report. An exit interview was conducted with Administrator Eunice Ambal, to whom a copy of this report, along with the Licensee/Appeal Rights (LIC9058 03/22), were provided at the conclusion of the visit. The signature below confirms that the documents were received. LPA requested and received during the inspection a current Designation of Administrative Responsibility (LIC 308), Personnel Report (LIC 500), and Emergency Disaster Plan (LIC610-E) .