Routine inspection·February 19, 2025

On 02/19/25, 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. Licensee(L1) Maria Emma Pangilinan. LPA toured facility with L1. All six residents were present during the inspection. Three residents were observed sitting in the living room. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. At 10:24AM, medications were checked and observed unlocked medication closet. Residents’ MARS were reviewed. At 12:16PM, tools were observed in kitchen drawer unlock. An adequate supply of perishable and non-perishable food was observed. Sharps and knives observed locked under kitchen sink and in kitchen drawer. Refrigerator temperature maintained at 38 degrees F and freezer maintained at 0 degree F. Fire extinguisher was observed with a service date of: 12/17/24. Chemicals observed lock in laundry room. Washer and dryer observed functional and operational during visit. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are observed with securely fastened grab bars and non-skid mat. Hot water temperature was tested range at 106.3 and 106.5 degrees F in master bathroom and 105.4 degrees F. in bathroom 1. Outside of facility toured and observed free of debris. Side gate was self-closing and self-latching. 5 out of 6 residents’ files were reviewed to have all required documents. A sample of staff files were reviewed to have all required documents. Carbon monoxide and smoke detectors were tested and observed to be operational. Technical Support Program (TSP) assistance was offered to Licensee. Licensee will make a decision and reach out the department regarding acceptance. A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 02/25/24. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, current Administrator Certificate, control of property, and current liability insurance. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of this report.