Routine inspection·December 2, 2024

On December 2, 2024 Licensing Program Analyst (LPA) Rachel Bruce conducted an unannounced visit and met with Administrator (AD) Ly Sy Jalao. The purpose of the visit was to conduct the Required Annual inspection. During this visit, LPA and AD toured the facility. The facility has a current census of 3. Resident rooms contained required furnishings and lighting. LPA observed required items in bathrooms with hot water measuring at 102.5 degrees F. Resident hygiene supplies were properly stored and available. The kitchen was toured observed in good repair with necessary items and appliances and sharps/knives were properly stored. LPA observed required emergency food supply and paper products. Medications are centrally stored and locked in pantry. Doors and passageways are unobstructed throughout the facility including outdoor patio. Facility has two First Aid kits, they are located in the kitchen pantry and in the emergency supplies. Both contained required items. Sufficient supply of perishable and non-perishable food observed. There is a Fire Extinguisher located on kitchen counter which was last serviced through February 2025. Smoke and Carbon Monoxide detectors are tested and found to be operational. LPA conducted resident and staff file reviews and required documentation was present in both. There are no deficiencies or technical violations issued at today's visit. An exit interview was conducted. A copy of this report was discussed and left with Administrator, whose signature on this form confirms receipt of this document. LPA is requesting the following documents be submitted to the Fresno CCL office by 12/30, 2024: Copy of property grant deed, 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 (LIC9020A), Surety Bond .