Facility Evaluation Report

On 02/15/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived at this facility unannounced to conduct an annual visit. LPA Pascua was greeted by Facility Designated Administrator, Cecil Kebe and explained the purpose of the visit. This facility is licensed to serve 6 residents who are deemed to be

ambulatory only. This facility is also vendorized by Valley Mountain Regional center to serve and accept Level 4I residents. The administrator has an active certificate #6012904735 and expires on 03/14/2024.

Current Census was 2. LPA Pascua reviewed 2 resident files. 2 out of 2 resident files were current and up to date. LPA Pascua reviewed 2 staff file which was current and up to date.

LPA observed a locked centralized stored medication cabinet located in the kitchen. Along with the administrator, the LPA observed, reviewed, and compared resident medication and medication dispensing logs. First Aid Kit was present and contained all of the required components.

A tour with FDA Kebe was conducted. Fire extinguisher located in the hallway was serviced by Assured Fire Service Company on 12/12/2023 and is in compliance in this time.

Dining areas, living areas, and all other areas intended for resident use were toured. It was observed that furniture and furnishings were sufficient and able to meet the needs of the residents at this time.

Kitchen area was toured. LPA observed a sufficient amount of 2 day perishable and 7 day non-perishable food supply to meet the residents needs. Knives were observed to be locked and made inaccessible to the residents in care.

A tour of the garage was conducted. Additional food supply was identified.