Facility Evaluation Report

On 01/30/2026, Licensing Program Analyst LPA K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection. Acting Administrator April McDowell allowed entry. LPA introduced self, stated the purpose of the visit

Facility has no residents at this time. LPA conducted a tour with Administrator. The facility was observed to be at a comfortable temperature, in good repair, with no passageway obstructions or fire hazards. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. Fire extinguisher in the Kitchen was last serviced on 04/14/2025 and was fully charged. All common areas were properly furnished and well-lit throughout. Medications, First Aid, Resident/Staff files, and Sharp are all kept locked in the Facility Office. Smoke Alarm and Carbon Monoxide detector tested and operational. LPA toured Kitchen, Dining Room, Living Room, Office, Bathroom, Staff Room, and 2 shared resident rooms. Extra linens kept in hallway closet. LPA toured the laundry area which appeared clean. The exterior tour was conducted. Backyard observed to have sufficient seating under covered patio. Staff records were reviewed for good health and training.

LPA is requesting the following documents be submitted to the Fresno CCL office by 2/06/2026: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan (LIC610D), Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020.

Exit interview conducted with Administrator. A copy of this report was provided to acting Administrator, whose signature on this form confirms receipt of this document.