Facility Evaluation Report

On 04/30/2026, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA Pascua was greeted by Staff Member (SM), Janet Murphy and Jessica Galvan and explained the purpose of the visit. LPA Pascua was able to speak with Facility Designated Administrator (FDA), Nicole Ell and explained the purpose of the visit. LPA Pascua was informed that FDA Ell was on her way to the facility. Shortly after, LPA Pascua met with FDA Ell and explained the purpose of the visit.

Current census was 4. Upon arrival at the facility LPA Pascua witnessed 3 residents board on a bus to go to Central Valley PACE. 1 resident was at the facility at the time of LPA Pascua's visit.

This facility is licensed to served 6 residents, all of whom may be non-ambulatory. This facility also has a dementia plan on file and has a current hospice waiver for 6. This facility is also vendorized by Valley Mountain Regional Center to serve and retain Level 6 elderly residents at this time.

LPA Pascua reviewed 4 resident files and 4 staff files. The facility administrator has a current certificate #700583740 and expires 08/16/2026. All resident and staff files were complete and up to date.

The interior of the physical plant was in good condition and sanitary. Fire extinguishers appeared to have been annual inspected by Assured Fire Company and is valid until 03/13/2027.

The kitchen area was toured. LPA observed a sufficient supply of 7 day non-perishable and 2-day perishable food supply in the pantry and refrigerator.

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