Facility Evaluation Report
On 5/1/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct a Post-Licensing Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Erwin Villarias, LPA was granted entry. 2 residents were present during inspection. Licensee (L1) Ronald Camilo arrived shortly after LPA’s arrival.
LPA toured facility with L1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Samples of resident’s medications were checked and observed locked in cabinet. Clients’ MARS was reviewed. Fire extinguisher reviewed with a purchase date of: 12/30/23 and does not expire for 5 years. Clients' bedrooms were toured and reviewed. Cleaning chemicals were observed stored and locked in cabinet. Residents bedrooms observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Hot water temperature was tested at a range of 111.9 to 114.9 degrees F in 2 bathrooms.
Outside of facility toured. Outside observed free of debris. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Freezer temperature observed at 0 degrees F and refrigerator temperature maintained at 37 degrees F. Smoke detectors and carbon monoxide were tested and observed to be operational. All clients’ files and staff’s files reviewed to have all the required documents. Technical Support Services recommended and accepted by Licensee.
No deficiencies issued during this inspection.
Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 5/22/25: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020)
A copy of this report with 9102 was provided to L1, whose signature on this form confirms receipt of this report.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction