Senior Care Records.

Facility Evaluation Report

Ambitions - Sumter Court, Visalia09/30/2025Licence 547208779

Capacity4
Date signed09/30/2025 12:02:04 PM
Name of licensing program analystJacques Leffall
Name of licensing program managerSee Moua
The inspector’s account

On 09/30/2025, Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. LPA was greeted by Staff (Staff) S1 Jaylyn Johnson. LPA met with Administrator (A1) Jessica Mata.

LPA conducted a tour of the facility with Administrator. 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 and had required furnishings and adequate lighting. Refrigerator temperature was measured at 30 degrees F. Freezer temperature was measured at 0 degrees F. Residents bathrooms appeared clean, water temperature measured at a range of 106.1 to 107.2 degrees F in 2 bathrooms. 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 during today’s visit. Fire extinguisher is current, last serviced on 12/6/24. Smoke detectors and carbon monoxide detector observed to operational. Last fire drill conducted on 09/15/2025. Cleaning supplies observed to be locked and inaccessible to residents in care. LPA reviewed client and staff files. Medications observed to be locked and administered as prescribed.

LPA is requesting the following documents be submitted to the Fresno CCL office by 10/14/2025: 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, Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020.

No deficiencies issued during today's inspection.

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

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction