Routine inspection·January 17, 2024

On 01/17/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and requested to meet with Administrator. LPA met with caregiver Brenda Munoz-Perez. Licensee (L1) Susan Blanza was called and stated unable to attend meeting. Administrator Petro Crisostomo arrived shortly and toured facility with LPA. All 5 residents were present upon inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. Fire extinguisher was observed with purchased date of 1/17/24. An adequate supply of perishable and non-perishable food was observed. Medications were checked and observed kept locked in dining room cabinet. MARS was reviewed. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured. All bathrooms were observed operating and functioning during inspection. Non-skid mat and grabbed bars were observed. Hot water temperature was tested between range 109.6 and 109.7 degrees in bedroom 4 bathroom. Hot water temperature was tested at 108.3 in bathroom. Outside of facility toured. Side gate was observed self-closing and free of debris. Adequate outdoor seating available for residents. All residents’ file reviewed to have Admission agreement, physician report and emergency information. LPA reviewed four staff files to have all required documents, fingerprinted cleared and associated to the facility. Carbon monoxide and smoke detectors were tested and observed to be operational. A deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached 809D. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 01/26/24. Forms requested: Lic 308, Lic 500, Lic 610E, and current liability insurance. LPA received a copy of current Administrator certificate and facility sketch. A copy of this report and appeal rights was provided to designee whose signature on this form confirms receipt of these report.