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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100406684
Report Date: 03/16/2022
Date Signed: 03/16/2022 12:37:16 PM


Document Has Been Signed on 03/16/2022 12:37 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:SIERRA VIEW HOMES RESIDENTIAL CAREFACILITY NUMBER:
100406684
ADMINISTRATOR:PENNER, VIRGINIA B.FACILITY TYPE:
741
ADDRESS:1155 E. SPRINGFIELDTELEPHONE:
(559) 638-9226
CITY:REEDLEYSTATE: CAZIP CODE:
93654
CAPACITY:78CENSUS: 50DATE:
03/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:31 AM
MET WITH:Virginia PennerTIME COMPLETED:
12:47 PM
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On 3/16/22, Licensing Program Analyst, M. Medina arrived at the facility unannounced to conduct the required Infection Control Inspection. LPA was greeted by screener, COVID screening was completed prior to LPA's entry. LPA observed a central entry point with a supply of hand sanitizer located upon entry. A sign in policy that includes documented routine symptom screening for visitors/staff is currently being implemented to follow current visitation guidelines. Mitigation plan was received. COVID-19 procedures are being implemented.

LPA toured the facility inside and out. Required postings of signs to include hand washing, coughing etiquette and physical distancing were observed throughout the facility. Staff were all observed wearing face coverings. LPAs observed a 30 day supply of PPE and resident medications. LPA observed a 7-day supply of non-perishable and 2-day supply of perishable food available.

LPA received copies of Administrator Certificate, CPR/First Aid, LIC 500, LIC 610E, resident roster and COVID visitor screening questionnaire during inspection visit

Through LPA's observation of documentation and interview with Administrator, the required infection control practices are found to be in compliance. No deficiencies were observed. Exit interview was conducted and report signed. Administrator was informed that as a COVID-19 precautionary measure, this report will be emailed.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/16/2022
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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