Facility Evaluation Report

On 12/18/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Facility staff granted LPA entry to the facility and contacted staff Juanita Ruiz. Administrator arrived a short time later. LPA met with Administrator. Four residents were present during inspection. Licensee/ Administrator Merilyn Bergstrom arrived later during visit.

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. Fire extinguisher was observed with a service date: 08/25/25. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature is maintained at 35 degrees F and freezer at -6 degrees F. Knives were observed locked in locked box. Cleaning supplies and chemicals stored and locked in laundry room and in the garage. Medications were observed locked in cabinet. Medication and MAR were checked and reviewed. Extra linens and towels were observed in the hall closet. All bedrooms were observed to have the required furnishings and adequate lighting. The bathrooms were toured. Non-skid mats and grabbed bars were observed. Hot water temperature was tested maintained at 113.5 and 114.3 degree F in hall bathroom and 110.5 and 111 degree F in the master bathroom. Outside of facility toured and observed to be free of debris. Adequate outdoor seating is available for residents. Side gate observed clear of obstruction. All residents’ and sample staff files were reviewed to have all required records. Smoke detectors and carbon monoxide were observed operational during visit.

A deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached Lic 809D.

Exit Interview conducted. The following documents are requested and to be submitted to Fresno CCL by: 12/24/25. The following updated forms were requested: Lic 500, Lic 610E, current liability insurance, current Administrator certificate, and Lic 9020. A copy of this report and appeal rights was provided to Licensee, via email.