Asagao Home Care

Type of visit: Required - 1 Year

On 8/19/2025 at approximately 09:45 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by the caregiver and stated the reason for their visit. The Co-Administrator, Jeorge Makinose arrived shortly after to assist with today’s visit. LPA asked for the census, Staff/Resident Roster, and Liability Insurance. LPA conducted a physical plant tour at approximately 12:00 PM and the following was noted: The facility is a single-story building with four (4) bedrooms and two (2) bathrooms. The facility is currently occupying four (4) residents. There is a designated staff room. The facility has an approved fire clearance for six (6) non-ambulatory residents of which one (1) may be bedridden. Hospice waiver approved for three (3). Common areas: The living rooms and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 75°F. LPA observed a fire extinguisher to be located near the kitchen and dated 01/06/2025. LPA observed required postings such as Long-Term Care Ombudsman, Emergency Disaster Plan, and Personal Rights to be located alongside the entrance. A working telephone was observed. LPA observed the fireplace to be covered and inaccessible to residents. Kitchen: The kitchen was observed to be clean and free from pests. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. Knives/sharps were observed to be kept in a locked kitchen drawer. The cleaning solutions/toxins were observed to be kept locked underneath the kitchen sink. Kitchen appliances were observed to be working and in proper condition. (continued on LIC 809-C) Bedrooms: The residents’ rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are lighted appropriately. Extra linens/covers were observed to be stored in cabinets located within the hallway’s passageway. Staff Room: LPA observed the staff room to be located near the kitchen. LPA observed staff and residents files to be kept in locked filing cabinet. Bathrooms: The bathrooms were checked for cleanliness and proper operation. The hot water temperature was measured within regulations. LPA observed appropriate grab rails and slip-resistant mats to be in proper condition. Laundry Room: The laundry room was observed to be kept locked. LPA observed cleaning solutions and toxins stored appropriately within the laundry room and inaccessible to residents. The laundry appliances were observed to be working and in proper condition. Garage: LPA observed the garage to be accessible through the laundry room. The garage was observed to be used for storage purposes. Backyard: The backyard of the facility is equipped with a designated shaded area with outdoor furniture for residents. There is no body of water located at the facility. Medications: The medications were observed to be kept in a locked cabinet located in the kitchen. First-aid kit observed to be equipped with but not limited to bandages, scissors, digital thermometer, tweezer and First-Aid Manuel. Smoke detectors and carbon monoxide observed to be working properly and were tested. Residents/Staff Records: LPA conducted a complete file review of resident records. One (1) of four (4) residents were missing their Tuberculosis (TB) screening. Staff records: LPA conducted a complete file review of staff records. Staff record appeared to be complete and updated. There were no other immediate health and safety hazards observed during the day of inspection. Citation issued, please refer to LIC 809-D. Exit interview conducted, Appeals Rights given, and a copy of this report was provided to the Administrator.the state’s words, verbatim · CDSS document, Aug 19, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA\) Gary Tan conducted an unannounced Required One (1) year visit at this facility. LPA met with co Administrator Jeorge Makinose and explained the reason for the visit. There is only one entrance being utilized at the facility, there are required poster posted at the main door. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Infection Control and Mitigation plan. The screen door however has a broken handle. Signs to wear a mask and other Covid 19 prevention protocol signs were posted outside and inside. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and all over the facility. The facility has a designated visitors' area upon entrance. The facility has sufficient stock of PPE in the storage room. At 9:42 AM, tour of the physical plant was conducted with the co Administrator. This facility is a single storey house and has five (5) bedrooms and two (2) bathrooms currently occupying two (2) residents. One (1) bedroom is designated for staff use. The facility is fire cleared for six (6) non-ambulatory residents, one (1) of which may be bedridden in Room #1, hospice waiver for three (3) residents. Physical environment was checked for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings, and doors were checked, the following was noted: Living and dining room furniture were also checked. The living room is neat and clean along with the dining room. The facility maintains a comfortable temperature at 74°F. The smoke detector is hardwired, tested and observed to be operational. There is a fire extinguisher located in the kitchen and observed to be full and last checked on 01/08/24. There is carbon monoxide detector installed at the facility. (continued on LIC 809-C) The backyard of the facility has outdoor furniture, with a covered shaded area for clients. There is no body of water in the facility. The Laundry room is located on the way to the garage. Laundry detergent and other cleaning agent are kept in a locked cabinet in the garage. Laundry room was observed to be locked during visit. The garage is also being used as frozen food, old equipment and other supplies storage. Food Service/Kitchen area was sufficiently stocked with two (2) days perishable and seven (7) days non-perishable food. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Cleaning supplies, laundry detergents, pesticides or toxins were stored in the kitchen cabinet and observed to be locked and inaccessible to residents. All sharps and knives were also observed to be locked in a kitchen drawer. The Clients' rooms are adequately furnished with appropriate furniture and lighting system. Hall ways/passage ways are lit to non-private rooms. Clients have sufficient amounts of personal hygiene product which is provided by the licensee. Staff Rooms: Staff room was also being used as an office. No medications are observed in the staff room. The bathrooms were checked for cleanliness and proper operation. LPA observed the appropriate grab bars for each toilet, bathtub and shower. The hot water temperature measured at a range of 106.8°F to 108.7°F. Towels and washcloths are not shared. There is enough clean linen available in stock at the cabinet. Medications: LPA observed medication in the kitchen cabinet to be locked and inaccessible to residents. Medications are listed on the centrally stored medication and destruction record. There are two (2) complete first aid kits located in the medication cabinet. Client and Staff records all residents and staff present records were reviewed. Residents and staff record appeared to be complete and updated. Disaster drill was last conducted on 08/24/24. Required posting are observed to be complete and current and displayed properly at the facility. Exit interview conducted and copy of this report issued.the state’s words, verbatim · CDSS document, Oct 5, 2024