Facility Evaluation Report

On 09/04/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct an annual visit. LPA Pascua was greeted by Staff Member (SM), Isabel Jimenez and explained the purpose of the visit. LPA Pascua asked for SM Jimenez to call the Facility Designated Administrator (FDA), Onyema Nkwocha to inform them that CCL was present at this time. Shortly after, LPA met with Licensee, August Nkwocha and and FDA Nkwocha and explained the purpose of the visit.

Current census was 4. 3 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.

LPA Pascua reviewed 4 resident files. 4 out 4 resident files were complete and up to date. FDA has a current and active administrator certificate #7036241735 and expires on 06/24/2025.

Fire extinguisher located in the kitchen appeared to have been annually inspected on 04/11/2024 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.