Facility Evaluation Report

On 10/24/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit and met with staff Rizaline Osuna. Licensee/Administrator Leticia Jackson was called and arrived shortly. All five residents were present during inspection. Residents were observed in the common area and in the bedrooms. LPA toured facility with Licensee.

The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. All residents’ bedroom were toured and observed to have the required furnishings and with adequate lightning. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature is maintained at 40 degrees F and freezer at -4 degrees F. Fire extinguisher was observed with a service date: 01/08/25. Last fire drill was completed on 10/01/25. At 10:24AM, medications were observed unlock on the kitchen counter next to the stove . Medications were check and MARs were reviewed. LPA toured kitchen and observed cleaning chemical stored and locked under kitchen counter. The bathrooms were toured. Non-skid mat and grabbed bars were observed. Hot water temperature was tested at 106.4 degree F in the bathroom 1 and maintained at 107.2 and 108.9 degree F in master bathroom. Extra linens and towels were observed. Outside of facility toured and observed to be free of debris. Side exit observed self-closing and self-latching. Adequate outdoor seatings available for residents. Sample of residents’ and staff files were reviewed. Carbon monoxide and smoke detector operational during visit.

A civil penalty is being cited, per California Code of Regulations, Title 22, Division 6, see attached 421IM. A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6.

Exit Interview conducted. The following documents requested to be updated and submitted to Fresno CCL by 10/30/25: Lic 308, Lic 500, Lic 610E, and current liability insurance. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of this report.