Routine inspection·October 8, 2025

On 10/06/2025, Licensing Program Analyst (LPA) M. Vega 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. LPA toured facility with Administrator - Jennifer Redubla. Facility has one main entrance/multiple exit point. LPA toured facility with Administrator inside and out. LPA observed back yard fenced, and the emergency exit was clear and free from obstruction. The facility was observed to be at a comfortable temperature, of 70 degrees F. Facility is free of debris, in good repair, and no fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPA observed there are no residents at this time. Department phone number and infection prevention information signs were in the entrance of 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. Fire extinguisher was observed with a service date of 04/10/2025. All 6 residents bedrooms were observed to be with comfortable temperature. Medications observed to be locked in a cabinet in the kitchen. Cleaning supplies were observed to be in a locked in laundry. An outdoor seating area was observed for residents in care with covering for shade. LPA reviewed Staff files. Staff files observed to have updated information, no residents at this time. Continuation on LIC 809 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 400 Affidavit Regarding Client/Resident Cash Resources LIC 402 Surety Bond LIC 500 Personnel Report LIC 610D Emergency Disaster Plan For Adult Residential Facility 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: 10/22/2025 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. No deficiencies issued during this inspection. An exit interview was conducted with the Administrator. A copy of this report was given to the Administrator whose signature on this form confirms receipt of this report.