Facility Evaluation Report
On 5/7/25 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Felimon Mangoagui. LPA was granted entry. 1 resident was present during visit. The other 3 residents were attending day program. Licensee Jose Pira arrived shortly after LPA’s arrival.
LPA toured facility with L1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at 0 degrees F and refrigerator temperature was maintained at 28 degrees F. Fire extinguisher was observed with a purchase date of: 4/3/25. Fire drill last completed on 4/2/25. Washer and dryer observed operational during visit. Carbon monoxide and smoke detectors were tested and observed to be operational. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. 1 resident bathroom toured and observed to be operational. Hot water temperature was tested at a temperature of 115 degrees F. All of the residents are non-ambulatory. All of the shower chairs were observed. Outside of facility toured. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for residents. Samples of medications were checked and observed kept locked in the cabinet. Residents’ MARS was reviewed. First aide kit observed with all of the required items.
All residents files and samples of staff files reviewed to have all the required documents.
No deficiencies issued during this inspection.
Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 5/21/25: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020)
A copy of this report was provided to Licensee, whose signature on this form confirms receipt of this report.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction