Facility Evaluation Report

On 06/03/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with House Manager (HM), Ricki Cantu and explained the purpose of the visit. The purpose of this visit was conduct an annual visit. Shortly after, LPA met with Facility Designated Administrator (FDA), Nicole Ell. There was one other staff member present, Jessica Galvan.

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 4I elderly residents at this time.

Current census was 4. Upon arrival, LPA Pascua observed 3 residents leave to their perspective day program. There was 1 resident present during the course of this visit.

LPA reviewed 4 residents files and 3 staff files. All files were complete and up to date.

The Facility Designated Administrator has a current and up to date administrator certificate #7005838740 and expires on 08/16/2026.

The interior of the physical plant was in good condition and sanitary. Fire extinguishers appeared to have been annual inspected by Jorgenson Fire Co and is valid until 03/18/2025.

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.