Facility has a fire clearance for 6 non-ambulatory residents and a hospice waiver for 1 resident. Penina Tuimaualuga, will be the Administrator of this facility. The facility administrator’s certificate #: 6056950740 and Expires: 06/30/2021. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, and kitchen. The facility was toured both indoor and outdoors with Penina Tuimaualuga.      .

The facility bedrooms are furnished with all required furniture. The facility bathrooms are furnished and sanitary. The living room, dinning room, and common areas are furnished. The facility has a public telephone. The facility has a fire extinguisher and expires on 03/16/2021. The facility has smoke detectors and carbon monoxide detectors. The facility water temperature was 105 degrees. The exterior of the facility is free of debris and has patio furniture. The facility has the required food supply, and has a emergency water and food kit.The facility has all required facility files and postings. The facility has a locked cabinet for medications. The facility has a medication binder for residents, and have personal medication storage boxes for residents. The facility has a first aid kit and a flash light

The applicant has passed the pre-licensing component of the application process. LPA will notify the Central Application Bureau (CAB) that the pre-licensing has been completed and passed. Component 3 was completed with LPA Kevin Gould. An exit interview was conducted with Penina Tuimaualuga via telephone, and a copy of this report was provided to Penina Tuimaualuga via email, and an electronic email read receipt confirms receiving these documents.