Facility Evaluation Report

On 5/7/2025, Licensing Program Analyst (LPA) J. Leffall 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 Administrator (A1) McKayla Turner. Administrator (A2) Renata Puckett arrived shortly after.

LPA toured the facility with the Administrator Turner. All pathways, entrances and exits were clear from obstructions. The tour started in the front room and continued dinning and kitchen. LPA observed sufficient seating in the front room. At the entry a door on the left leads to activities room and a salon area. Dining room has sufficient tables and chairs. LPA observed 3 residents watching television in theater room. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. Tour continued to Residents Rooms. LPA toured several bedrooms which were observed to be furnished with required furniture and adequate lighting. Bathrooms were properly equipped with non-slip mats and grab bars. Fire extinguisher in hallway was last serviced on 8/14/2024 and was fully charged. Linen supply is kept in the laundry room. Cleaning supplies and chemicals are kept locked in hallway closet. Medications are kept in 2 locked Med carts in the staff office. LPA observed sufficient seating under covered patio area in the back of the facility. Resident's records contained signed Admission Agreement, Personal Rights, and current Physician's Report. Staff files were reviewed to have all of the required documents. It was verified that there are at least two staff on duty who is CPR certified. Medication review conducted. LPA observed 2 medications not logged in MARS sheet. First Aide kit observed to have all of the required items.

Deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6.

LPA is requesting the following documents be submitted to the Fresno CCL office by 5/21/2025: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan, Personnel Report (LIC500), Register of Facility Clients/Residents LIC9020.

Exit interview conducted. A copy of this report, with 809D and appeal rights were provided to A1 whose signature confirms receipt of this report.