Facility Evaluation Report

On 12/06/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Facility Designated Administrator (FDA), Christine Quiruz and explained the purpose of this visit.

This facility is vendorized by Valley Mountain Regional Center to be able to accept and retain up to (4) Level 4I residents at any given time.

This facility is licensed to serve up to (4) Ambulatory only residents at any given time.

Current census was 3. 3 out 3 residents were out of the facility at this time.

A brief interview with FDA Quiruz was conducted.

The facility administrator has an pending administrator certificate renewal. LPA was able to verify that this renewal was sent in prior to the past administrator certificate expiration date.

A review of 3 resident files and 3 staff files were conducted. Both staff and residents files were complete and up to date.

The interior of the physical plant was in good condition and sanitary. Fire extinguishers appeared to have been annually inspected by Armor Fire Extinguisher Company 05/17/2024.

The kitchen area was toured. LPA observed a sufficient seven days of non-perishable foods as well as two days worth of perishable food supplies in the main kitchen. Additional perishable food was identified in the additional freezer in the garage.

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.

A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees.

A tour of the resident bedrooms was conducted. Resident furniture was observed to be sufficient to meet the resident needs at this time.