Facility Evaluation Report

On 3/24/26, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required inspection. LPA arrived, introduced self, provided identification, and allowed entrance into facility by Direct Care Staff. Staff contacted Rosanda Anderson by telephone and were unable to make contact with her. Sally Jackson, House Manager contacted by telephone and arrived a short time later to conduct visit with LPA.

Facility observed to be clean, odor free, and a comfortable temperature. Currently, there are three (3) residents in care, all residents were present at time of inspection. LPA toured resident bedrooms and observed bedrooms to have required furnishings, LPA observed the window screen in bedroom #2 to be torn and in need of repair. Resident bathrooms toured and observed to have grab bars, shower chair, and non-skid mat available. Fixtures observed operational, water measured at 110 degrees F. Kitchen toured, LPA observed the wall in kitchen nook in need of repair. Facility observed to have a 2-day supply of perishable and 7-day supply non-perishable food available. knives observed to be locked and secured.

Outside of facility toured, LPA observed adequate seating and shading available for residents in care. All exits observed to open free of obstruction. The following items were observed during outside tour: a broken, recliner on the back patio, a wood patio set which includes broken chairs near garage, 2 inoperable vehicles parked in driveway. Garage observed to have Christmas decorations, 2 hoyer lifts, washer, dryer, bedrails and miscellaneous items. All items need to be removed or secured.

Administrator to submit current LIC 500 and LIC 9020 to Fresno Regional Office no later than Friday, April 3, 2026.

All deficiencies observed are being cited on the attached 809-D.

Exit interview conducted. A copy of this report provided to House Manger for facility records.