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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100404229
Report Date: 07/08/2024
Date Signed: 07/12/2024 09:40:42 AM

Document Has Been Signed on 07/12/2024 09:40 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:STEPHANIE'S HOUSE A HOME FOR SPECIAL PEOPLEFACILITY NUMBER:
100404229
ADMINISTRATOR/
DIRECTOR:		SNYDER, ELSA V.FACILITY TYPE:
735
ADDRESS:42825 WEST VALERIATELEPHONE:
(209) 392-3778
CITY:DOS PALOSSTATE: CAZIP CODE:
93620
CAPACITY: 13CENSUS: 13DATE:
07/08/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:31 AM
MET WITH:Staff Maria AguilarTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On 7/8/24, Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to conduct a required Annual Inspection visit. LPA introduced herself, stated purpose of visit, and was allowed entrance by Staff Maria. Administrator Elsa Snyder was contacted, and was not able to attend the annual inspection visit. Staff Maria conducted the inspection with LPA B. Miranda.

LPA toured the facility inside and out including entry, kitchen, living room, bedrooms, bathrooms, and exterior. LPA observed the facility to be clean, clutter free, and odor free. LPA observed staff interacting with residents during LPA's visit. All fire exit routes were free and clear of obstructions. Medications are stored in a locked cabinet. Toxins, cleaning supplies, knives and sharp objects are locked and secure.

Facility has 14 bedrooms and 5 bathrooms. Resident’s do not share bedrooms. Fire extinguishers have been services as of 12/27/23 and are in good standing. Smoke alarms were tested and are in working condition. Carbon monoxide detectors were tested and in working condition.

A continuance of this inspections will be conducted at a later time. No citations were issued at this time.

Exit interview was conducted and a copy of this report LIC809 was provided to Staff Maria Aguilar.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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