Facility Evaluation Report

On 04/28/23, Licensing Program Analyst (LPA) M. Yang arrived at the facility unannounced to conduct a continuation of the Required Annual Inspection. LPA met with Administrator Paul Anderson and Director of Residential Services Shellie Whitlock and stated the purpose of the visit.

A sample of the residents’ file reviewed to have update emergency contacts, Admission agreement, and physician report.

A sample staff files were also reviewed. Staff files were observed to have current First Aid/CPR, Personal Record, and TB results.

No deficiencies issued during this inspection.

An exit interview was conducted. The following documents are requested and submitted to Fresno CCL by: 5/05/23. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, current liability insurance, Theft and Los procedure/policy, and current Administrator Certificate. A copy of this report was provided to Licensee, whose signature on this form confirms receipt of these report.