Facility Evaluation Report
On 05/9/2024, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by Licensee Marietta Diaz.
Tour was conducted with Licensee Marietta Diaz. All pathways, entrances and exits were clear from obstructions. LPA and staff began the tour at the facility kitchen. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. Fire extinguisher in the kitchen observed operational with service date of 8/4/2023. Tour continued to laundry room which has locked chemicals and cleaning supplies. LPA observed a staff room, storage area and staff bathroom. Fire drill conducted on 4/22/2024.
Tour continued to the living room which has sufficient seating and office area. LPA toured two more staff rooms with bathroom in hallway. Medications, PPE supplies, and files are locked in hallway closet. LPA toured three resident bedrooms which were observed to be furnished with required furniture and adequate lighting. Bedroom share a bathroom. Linen and hygiene supply is kept in the hallway closet. Carbon monoxide and smoke alarm detectors installed and operational. LPA reviewed resident’s medication and Centrally Stored List for all residents. LPA reviewed Resident's records contained signed Admission Agreement, Personal Rights, and current Physician's Report. Staff files were reviewed for good health, First Aid training. LPA observed sufficient seating under covered patio area in the back of the facility. Backyard gate was self-latching and self-closing.
No deficiencies issued during this inspection.
LPA is requesting the following documents be submitted to the Fresno CCL office by 5/16/2024: 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 (LIC610D), Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020.
An exit interview was conducted with Licensee. Report signed on-site; printed copy provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction