Facility Evaluation Report

On 10/07/2024 at 9:30am, Licensing Program Analyst (LPA) Arielle Pascua arrived announced to this facility to conduct a pre-licensing visit. LPA was greeted by applicant, Topeka Jackson and explained the purpose of the visit.

This facility may house 4 ambulatory residents between the ages of 18-59. In addition, this facility is awaiting vendorization from Valley Mountain Regional Center to accept and retain Level 4I residents at this time.

Current census was 0. A brief interview with applicant Jackson was conducted.

The applicant has a current administrator certificate #6069528735 and expires on 12/02/2026.

A tour of the facility was initiated with Applicant Jackson.

A tour of the kitchen was conducted. LPA observed a sufficient amount of 2-day perishable and 7 day non-perishable food supply. LPA observed knives and toxins locked and made inaccessible to residents in care. A fire extinguisher was also located in the kitchen and was serviced by the Local Fire Complaint Armor Co on 03/14/2024.

A tour of the back yard was conducted with no hazards present. Perimeter fence and exit gates were observed to be in good repair.

A tour of the living area, dining area, and other areas intended for resident use was conducted. Furniture was observed to be in good repair and meet resident needs.

A tour of 2 bathrooms were conducted. Hot water was taken to ensure compliance within regulation.

A tour a 3 resident bedrooms were conducted. Resident furniture was observed to be in good repair and meet residents needs. An additional staff bedroom was toured.

A tour of the laundry room was conducted. Toxins and other cleaning supplies were identified and made inaccessible to residents in care.

A linen closet located in the hallway was tour and present a sufficient amount of linens to meet the residents needs.