Facility Evaluation Report
On 12/19/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct a case management - annual continuation. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. LPA met with Administrator, Leslie Richard.
There are currently no residents residing in the facility and the facility is not staffed.
Facility tour conducted with Licensee. All pathways, entrances and exits were clear from obstructions. No fire clearance issues. LPA checked food supply, observed an adequate supply of food. Bathrooms are stocked with liquid soap and paper towels. Bedrooms toured. LPA observed required furnishings.
LPA is requesting the following documents be submitted to the Fresno CCL office by 01/06/2023: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan (LIC610-D), Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020.
Exit interview conducted. A copy of this report was discussed and provided to Administrator, Leslie Richard, whose signature on this form confirms receipt of this document.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction