Facility Evaluation Report

On 07/09/2024, LIcensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct an annual visit. LPA was greeted by staff member (SM), Edith Aiukwe and explained the purpose of the visit. LPA asked that SM Aiukwe call the Facility Designated Administrator (FDA), Oyema Nkwocha and notify him that CCL was present at this time. Shortly after, FDA Nkwocha arrived at the facility and met with LPA Pascua. The purpose of this visit was to conduct an annual visit.

This facility is licensed to serve 4 residents, of which 1 may be non-ambulatory. This facility is also vendorized by Valley Mountain Regional Center to accept and retain Level 4I residents at this time.

Current census was 4. 1 out 4 residents were out at their respective day programs. 1 out 4 residents were out at the hospital. 2 out 4 residents were observed to be in their rooms upon entrance to the facility.

LPA reviewed 4 resident files. LPA reviewed 5 staff files.

The fire extinguisher, located in the front hallway, was serviced by Jorgensen Fire Company and is valid on 03/11/2024. 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.