Facility Evaluation Report

On 3/23/2023, Licensing Program Analyst (LPA) K. Kaur arrived unannounced at the above facility to conduct an Annual Inspection. LPA was allowed entry by Licensee Christine Sandoval.

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. Hand washing and other various Covid-19 related signs were observed in the common areas. 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 6/16/2022 and was fully charged. Trash cans observed with lids. Common areas were properly furnished and well-lit throughout.

LPA toured 3 private bedrooms with adequate furnishings and restrooms observed to be clean, odor free and functioning at time of visit. Hand washing posters were observed in the bathrooms by the sink. Additional cleaning supplies and locked in hallway closet. Backyard observed to have sufficient seating. Backyard gate was self-latching and self-closing. A sample of medication was reviewed. Staff and resident records were reviewed for updated emergency contact information and health screening.

No deficiencies issued during this inspection.

LPA is requesting the following documents be submitted to the Fresno CCL office by 3/30/2023: 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.