Facility Evaluation Report

Unannounced case management visit made out to this facility on 10/09/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility live-in caregiver, Loveth Ogbuehi, who was briefly interviewed at this time. This LPA requested that she go ahead and contact the facility designated Administrator, Victoria Ogbuehi- Nzambi, to inform her that CCL was present at this time.

The facility designated Administrator arrived shortly thereafter to this facility. An interview was conducted with the facility designated Administrator at this time.

Current census was (5) residents , of which all of them, were out of the facility at this time at their respective day programs at this time.

The purpose of this case management visit was to discuss an incident that was reported to this department and gather additional forms and documents related to this incident.

The following forms and documents were requested by this LPA at this time:

Most current IPP from Valley Mountain Regional Center (VMRC) for R1

Medication Administration Record (MAR) for R1

There were no deficiencies observed or cited during today's case management visit.