Facility Evaluation Report

On 10/07/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Facility Designated Administrator (FDA), Corazon Poier and explained the purpose of the visit. The purpose of this visit was to conduct an annual visit.

Current census was 5. A brief interview with FDA Poier was conducted.

This facility is licensed to serve and retain Level 3 residents from Valley Mountain Regional Center.

LPA reviewed 2 staff files and 2 resident files. All files were complete and up to date.

The facility administrator has a current administrator certificate #6004322735 and expires on 1/18/2025.

Fire extinguisher located in the living room appeared to have been annually inspected on 02/15/2024 by the local fire company.

The kitchen area was toured. LPA Pascua observed a sufficient seven days of non-perishable as well as two days worth of perishable food supplies in the main kitchen. Additional perishable supplies were identified in an additional freezer located in the garage. Knives and additional cleaning supplies were locked and made inaccessible to the residents at this time.

LPA Pascua observed a locked centralized stored medication cabinet located in the living room. Along with Facility Designated Administrator, the LPA observed, reviewed, and compared resident medication with the medication dispensing logs. First Aid Kit was present and contained all of the required components.

Common areas were toured. Living room, dining area and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time.

A tour of the garage was conducted. Additional storage for supplies were stored in cabinets. A washer and dryer were also identified in the garage. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time.