Facility Evaluation Report

On 06/17/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct an annual visit. LPA was greeted by Staff Member (SM), Ester Cervantes and explained the purpose of the visit. There were two other staff members present, TJ Castro and Jazmin Virrueta. LPA asked that the staff call the Facility Designated Administrator (FDA), Jessica Dizon to inform her that CCL was present at this time. At 12:00pm, LPA Pascua met with FDA Dizon.

Current census was 5. 3 out 5 residents were out at the respective day programs at this time. A brief interview with FDA Dizon was conducted.

This facility is licensed to serve up to 6 ambulatory residents. This facility is also vendorized by Valley Mountain Regional Center to accept and serve 4I residents at this time.

LPA reviewed 5 resident files and 5 staff files. All resident and staff files were current and up to date. The facility designated Administrator does not have a current administrator certificate however the LPA has verified that the administrator has sent in renewal documentation prior to the administrator certificate expiration date on 03/28/2024 and is awaiting renewal from the department at this time.

LPA toured the facility with FDA Dizon. Smoke detectors and carbon monoxide was observed to be in good repair.

The kitchen area was toured. Food supply was reviewed. 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 and non-perishable food supplies were identified in the garage. Knives were observed to be locked in a kitchen cabinet and made inaccessible to the residents at this time. Fire extinguisher located in the kitchen was serviced on 03/04/2024.

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.