Routine inspection·July 25, 2025

On 07/01/2025, Licensing Program Analyst (LPA) M Vega arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self to staff, stated the purpose of the visit, and was granted entry to the facility. Administrator was notified of Licensing visit over the phone and was able to attend the visit. LPA toured the facility with facility Administrator (AD) - Irina Chernyakova. The facility was observed to be at a comfortable temperature, of 75 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPA observed residents in their rooms resting. Department phone number and infection prevention information signs were posted thought the facility. Inspecting kitchen LPA observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. A fire extinguisher was observed with a service date of 08/19/2024. All six private residents’ bedrooms were observed to be at comfortable temperatures. The bathroom’s water temperature was tested and recorded reading of 116.4 degrees F a second restroom was tested and recorded reading of 110.8 degrees F. Medications observed to be locked in a cabinet in the common area. LPA reviewed medication records administered properly at the time of annual visit. Cleaning supplies were observed to be in a locked cabinet in the laundry room, some cleaning supplies secured under the kitchen sink as well. An outdoor seating area was observed operational for residents in care. continued on LIC 809C Community Care Licensing (CCL) is always striving to have facility files that reflect the most accurate & up to date information for your facility. In an effort to maintain your facility file, please submit the most current & complete forms &/or information as identified below: Residential Care Facility for the Elderly (RCFE): LIC 308 Designation of Facility Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly LIC 9020 Register of Facility Clients/Residents Copy of current Liability Insurance Copy of current Administrator Certificate Alternate contact information including name, telephone number, & email address. Please submit the above forms/information to Fresno CCL by: 08/07/2025 As an operator of a Community Care Licensed facility it is your responsibility to be aware of and in compliance with all regulations, including Chaptered Legislation. Go to www.ccld.ca.gov to stay updated and informed.