Facility Evaluation Report

On 01/08/2026, Licensing Program Analyst (LPA) Arielle Pascua arrived announced to this facility to conduct an annual visit. LPA Pascua was greeted by Direct Care Staff (DCS), Mae Acshah T. Obregon and explained the purpose of the visit. LPA Pascua asked DCS Obregon to call the Facility Designated Administrator (FDA), Linda Payang to inform her that CCL was present. Shortly after, LPA Pascua met with FDA Payang.

Current census was 4. There were currently 2 residents present at the time of this visit. A brief interview with FDA Payang was conducted.

LPA Pascua reviewed 4 resident files and 4 staff files. All files were complete and up to date. All current staff have an active first aid certificate and have been background cleared.

This facility has an approved fire clearance for 5 residents, of 3 may be non-ambulatory and 2 may be bedridden in rooms 1 and 3. This facility is has current vendorization from Valley Mountain Regional Center to accept and retain Level 6 residents at this time.

The applicant has an active administrator certificate #7018694735 and expires on 04/22/2027.

Fire extinguishers located throughout the facility were serviced by Nor Cal Fire on 05/14/2025 and is in compliance at this time. There is also a generator on site.

A tour of the living, dining room, and other rooms intended for resident use was toured. Furniture was observed to be in good repair and meet the residents needs.

A tour of the kitchen was toured. LPA observed a sufficient supply of 2 day perishable and 7 day non-perishable food supply. A medication cabinet was observed. Along with the FDA, LPA reviewed and compared medication with medication dispensing logs.