Facility Evaluation Report

On 11/13/2023, Licensing Program Analyst (LPA) Walton 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 contacted Administrator, Shannon Sayson, who arrived a short time later. LPA met with Administrator.

LPA conducted a tour of the facility. During the inspection the facility appeared clean and odor free and at a comfortable temperature. Common areas were furnished and had adequate seating and lighting available. Resident bedrooms appeared clean. Residents bathroom appeared clean, water temperature measured at 110.9 degrees F. Facility kitchen appeared to be clean and safe for food preparation. LPA observed 2-day supply of perishable foods and a 7-day supply of non-perishable food.

Exterior tour conducted, all exits open and free of obstructions on today’s visit. Fire extinguisher is current with a service date of 09/11/2023. Smoke detectors and carbon monoxide detector observed to operational. Last fire drill conducted on 10/16/2023. Cleaning supplies observed to be locked and inaccessible to residents in care. LPA reviewed client and staff files. Medications and MARs were reviewed. Medications observed to be locked and inaccessible to clients.

LPA is requesting the following documents be submitted to the Fresno CCL office by 11/27/2023: 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 (LIC610D), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020), Surety Bond.

No deficiencies issued during today's visit. Exit interview conducted. A copy of this report was discussed and provided to Administrator, Shannon Sayson, whose signature on this form confirms receipt of this document.