Facility Evaluation Report

On 06/13/2025, Licensing Program Analyst (LPA) Arielle Pascua unannounced to conduct an annual visit. LPA was greeted by Staff Member (SM), TJ Virrueta and explained the purpose of the visit. LPA asked that the staff call the Facility Designated Administrator (FDA), Jessica Dizon to inform her that CCL was present at this time.

Current census was 6. 3 out 6 residents were out at the respective day programs at this time. One resident was currently visiting from a separate facility at the time of this visit. 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 level 6 residents at this time.

LPA reviewed 4 resident files and 4 staff files. All resident and staff files were current and up to date. The facility designated administrator has an active and current administrator certificate, #7008894735 and expires on 03/30/2026.

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 02/24/2025.