Facility Evaluation Report

On 09/27/2023, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct an annual visit. LPA was greeted by Staff Member, Isabel Jimenez and explained the purpose of the visit. LPA asked that SM Jimenez call the Facility Designated Administrator to inform them that CCL was present at this time. At 11:30am, LPA met with Licensee Augusta Nkwocha and FDA Onyema Nkwocha and explained the purpose of the visit. There was one other staff member present at this time, Sheriff Kabba.

Current census was 4. 2 out 4 residents were out at their respective day program.

This facility is licensed to serve 4 residents, of which all my be non-ambulatory. This facility is also vendorized by Valley Mountain Regional Center to serve and retain Level 4I residents at this time.

The Facility Designated Administrator does not have an active current administrator certificate at this time, however, has sent in the necessary documents for renewal before the expiration date and is awaiting for the department at this time.

LPA reviewed 4 resident files and 4 staff files all of which were current and up to date.

Fire extinguisher located in the kitchen appeared to have been annually inspected on 04/26/2023 by the local fire company, Fire Code and is weekly inspected by Facility Designated Administrator.

The kitchen area was toured. LPA Pascua observed a sufficient seven days of non-perishable as well as two days worth of perishable food supplies in the main kitchen. Additional perishable supplies were identified in an additional freezer located in the garage. Knives and additional cleaning supplies were locked and made inaccessible to the residents at this time.

LPA Pascua observed a locked centralized stored medication cabinet located in the living room. Along with Facility Designated Administrator, the LPA observed, reviewed, and compared resident medication with the medication dispensing logs. First Aid Kit was present and contained all of the required components.

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.

A tour of the garage was conducted. Additional storage for supplies were stored in cabinets. A washer and dryer were also identified in the garage. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time.