Facility Evaluation Report

On 02/23/2026, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA Pascua met with Business Office Manager (BOM), Goshang Vang and explained the purpose of the visit. It was learned at this time that Facility Designated Administrator (FDA), James Hall was out of the office at this time and would meet LPA Pascua at a later time.

At 2:45PM LPA Pascua was met by FDA James Hall.

This facility is licensed to serve and retain 58 ambulatory residents and 26 non-ambulatory residents. This facility also has a dementia plan in file and a holds a hospice waiver for 10 residents.

Current census was 51. A brief interview with FDA Hall was conducted. FDA Hall has a current and active administrator certificate #7014180740 and expires on 11/19/2027

LPA Pascua reviewed 5 staff files. 5 out 5 staff files were complete and up to date. LPA Pascua reviewed 6 resident files. It was observed that 1 out 6 residents did have an updated care plan, however, review of this resident's medical assessment showed that the resident's needs were not properly identified as assessed by the facility. Technical Assistance was provided regarding Dementia Regulations, resident assessments, and best practices regarding these topics.

A brief tour of the facility was conducted.

Due to insufficient time to review additional files. The department will come at a later date to complete the annual visit.

The following forms were obtained during this visit: LIC308, LIC400, LIC 500, and LIC610E.

There were no deficiencies observed or cited during today's annual visit. An Exit Interview was conducted and a copy of this report was provided to the administrator at the end of this visit.