Facility Evaluation Report

On 7/06/2026, 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 Staff. Executive Director/ Administrator Renata Puckett arrived shortly after.

LPA toured the facility with Executive. All pathways, entrances and exits were clear from obstructions. Facility noted to be maintained at a comfortable temperature. Resident lobby & dining room are sufficiently furnished and observed with adequate lighting. LPA observed 4 residents playing a card game in the dining room/ activities area. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. 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 8/4/2024 and was fully charged. Linen supply is kept in the laundry room. Cleaning supplies and chemicals are kept locked in hallway storage closets. 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. Facility fire alarm system is inspected annually. Fire drill conducted on 6/11/2026. Resident's records contained signed Admission Agreement, Personal Rights, and current Physician's Report. Staff files were reviewed for good health. It was verified that there are at least two staff on duty who are CPR certified. Medication review conducted. LPA observed three doses of PRN medication were not logged.

Deficiency is 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 7/13/2026: 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. An exit interview was conducted with Administrator. Report signed on-site; a copy of this report, 809D with appeal rights were provided.