Facility Evaluation Report

On 03/27/2026, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Facility Designated Administrator (FDA), Marisa Tojino and explained the purpose of the visit. The purpose of this visit was to conduct an annual visit at this time.

Current census was 4. 3 out 4 residents were out at their respective day programs. This facility is currently licensed to hold 6 residents and is vendorized by Valley Mountain Regional Center to hold and accept Level 4G residents at this time. A brief interview was conducted with FDA Tojino.

LPA reviewed 5 staff file and 3 resident files. All 5 staff files and 4 resident files were complete and up to date. FDA Tojino has an expired administrator certificate however was sent over to the department prior to 12/28/2024.

A tour with FDA Tojino was conducted. Fire extinguisher located in the hallway was serviced by Assured Fire Service Company on 08/22/2025 and is compliance at this time.

Dining areas, living areas, and all other areas intended for resident use were toured. It was observed that furniture and furnishings were sufficient and able to meet the needs of the residents at this time.

Kitchen area was toured. LPA observed a sufficient amount of 2 day perishable and 7 day non-perishable food supply to meet the residents needs. Knives were observed to be locked and made inaccessible to the residents in care.