Facility Evaluation Report

On 4/18/2023, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection. LPA was allowed entry by Staff Elizabeth McIntosh. Licensee was contacted and would be arriving shortly.

The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed. Hand sanitizer was readily available to residents and visitors. Sharp items and chemicals are locked under the kitchen sink. Cleaning supplies were locked and secured in laundry room. 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 6/16/2022 and was fully charged. Common areas were properly furnished and well-lit throughout.

LPA toured 3 bedrooms which are shared. LPA observed 1 live in staff bedroom. All clients’ bedroom toured and observed to be adequately furnished and lit and restrooms observed to be clean, odor free and functioning at time of visit. The exterior tour was conducted. Backyard observed to have sufficient seating. Backyard gate was self-latching and self-closing. Medication was reviewed. Staff records were reviewed for good health and infection control training. All clients’ records reviewed to have updated emergency contact information. Last fire drill: 4/8/2023. No deficiencies issued during this inspection.

LPA is requesting the following documents be submitted to the Fresno CCL office by 4/25/2023: 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 Licensee. Report signed on-site; and a printed copy was provided.