Facility Evaluation Report

On 3/11/2025, 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 Elizabeth Lee.

LPA conducted tour with Licensee. 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 5/13/2024 and was fully charged. All common areas were properly furnished and well-lit throughout. Medications are kept on the counter in a locked box. First Aid and files in facility office. Chemicals and cleaning supplies are locked in hallway closet. Smoke Alarm and Carbon Monoxide detector tested and operational. All client bedrooms toured and observed to be adequately furnished. LPA observed two bedrooms that are single occupant and two vacant bedrooms and an office.

LPA toured laundry area which appeared clean. Cleaning supplies and chemicals observed locked in Hallway closet next to laundry. The exterior tour was conducted. The backyard was observed to have sufficient seating under covered area. Medication was reviewed. Staff records were reviewed for good health and training, all clients’ records reviewed to have Admission Agreement, Physician’s Report and emergency contact information. Last fire drill completed on 2/15/2025.

No deficiencies were observed during this inspection.

LPA is requesting the following documents be submitted to the Fresno CCL office by 3/18/2024: 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.

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