Facility Evaluation Report
On 5/06/2024, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection. LPA was allowed entry by care staff Febe Tinoco. Licensee Deena Patch was contacted and arrived a short while later.
The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed. Sharp items and medications are locked in the kitchen cabinet. Cleaning supplies were locked under the kitchen sink. 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 10/9/2023 and was fully charged. Common areas were properly furnished and well-lit throughout. LPA toured 3 private bedrooms with adequate furnishings and 2 restrooms observed to be clean, odor free and functioning at time of visit. Facility has in live in staff in one bedroom. Additional cleaning supplies and laundry detergent locked in garage. Hallway closet observed to have additional bedding, linens, and hygiene products. Backyard observed to have covered patio with sufficient seating. Backyard gate was self-latching and self-closing. A sample of medication was reviewed. Resident records were reviewed for updated emergency contact information and for all necessary documentation. LPA observed during medication review Centrally Stored medication and destruction record was missing information. Staff records were reviewed for health and first aid. Last Fire drill conducted on 2/21/2024.
Deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22,
LPA is requesting the following documents be submitted to the Fresno CCL office by 5/13/2024: 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
(LIC610E), Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020.
An exit interview was conducted with staff. Report signed on-site; and a printed copy was provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction