Facility Evaluation Report

On 08/05/25, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to conduct the required Annual Inspection Visit. LPA was greeted by Licensee and staff, stated the purpose of the visit and was allowed entry into the facility. LPA met with Administrator provided a tour of the facility inside and out.

LPA observed 1 resident in care at the time of visit. Facility is a 3 bedroom 2 bathroom home. Residents bedrooms were observed to have the required lighting and furnishings and were free from odor and free from any passageway obstruction / fire hazards. Facility temperature was 74 degrees F. Bathrooms were toured and observed to have operational lights, running water, and non- slip floors. Hot water temperature tested at 106.5 degrees F. Trash can with lid and hand washing postings were observed. Medications were observed to be locked in a cabinet in the hallway. Cleaning supplies were observed to be locked in the garage. LPA toured the kitchen observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. Carbon monoxide and smoke detectors were observed to be operational. Fire Extinguisher was observed with a service date of 03/21/25. First aid kit was observed and contained all required items. A covered outdoor seating area was observed for residents in care. Side gate was self-closing and self-latching. The exterior tour of back yard was conducted and found to be free from debris. A covered outdoor seating area was observed for residents in care. Side gate was self-closing and self-latching.

Emergency Disaster Drill logs were observed for staff. LPA observed on the LIC 610D (Emergency Disaster Plan) with emergency numbers and evacuation’s locations was posted in the office. A sample of Resident reviewed and observed to have update emergency contacts, Admission agreement, and current physician report/individual performance plans (IPP). A sample of staff files were also reviewed. Staff files were observed to have current First Aid/CPR. No deficiencies observed on todays visit.

The following documents are requested and submitted to Fresno CCL by: 08/15/25:

LIC 308, LIC 400, LIC 402, LIC 500, LIC 9020 Copy of current Administrator certificate and Emergency and Disaster Plan LIC 610D.