Facility Evaluation Report

On 05/08/2023 at 10:00am, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Licensee Augusta and Onyema Nwocha and explained the purpose of the visit. This facility is licensed to serve 4 residents, 1 one which may be non-ambulatory. This facility is awaiting vendorization from Valley Mountain Regional Center to serve and retain 4I residents.

The fire extinguisher, located in the front hallway, was serviced by Jorgensen Fire Company and is valid until 07/20/2023. All smoke detectors were present and working at this time.

Four resident bedrooms were toured. Furniture and furnishing were observed to be present and in good condition. An office was toured and was observed to be in good repair.

Laundry area was toured. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time.

A linen closet was located in the hallway. LPA observed a sufficient amount of linens at this time.

A tour of the bathrooms was conducted. Hot water temperatures were taken to ensure that the hot water being dispensed was within the allowed range of 105-120 degrees at all times.

The kitchen area was toured. Facility freezer and refrigerator showed to be functional and in compliance at this time. LPA observed that there was a sufficient amount of 2-day perishable and 7-day nonperishable food supplies available at this time.

Garage area was toured. LPA observed a refrigerator which will store additional food supplies. Additional storage for supplies were stored in cabinets.

This facility will be using a medication cabinet which was located in the living room. LPA observed the medication cabinet to be locked and made inaccessible at this time.

First aid kit was observed to be present and contained all of the required components at this time.