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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100408901
Report Date: 01/08/2024
Date Signed: 01/08/2024 02:47:55 PM


Document Has Been Signed on 01/08/2024 02:47 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
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:GARDEN MANORFACILITY NUMBER:
100408901
ADMINISTRATOR:BLACK, JOANFACILITY TYPE:
740
ADDRESS:4983 E. OLIVETELEPHONE:
(559) 255-8650
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:49CENSUS: 33DATE:
01/08/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Joanna Tilghman, Assistant AdministratorTIME COMPLETED:
02:48 PM
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Licensing Program Analyst (LPA) L.Padgett conducted an unannounced POC visit and met with facility Assistant Administrator Joanna Tilghman (AD) to verify correction of citation 87303(e)(2) issued during Annual Inspection conducted on 1/4/2024. LPA and AD toured the 7 buildings at this facility and water temperature was check in the bathrooms. Water temperature was as follows: Main House 106.4 and 105 degrees F. Building 1, 110.1 degrees F. Building 2, 105.4 degrees F, Building 4, 116.7, Building 5 110.8 degrees F, Building 6 118.9 degrees F. Building 3 was not rechecked by LPA as it was being used by a resident. Per maintenance notes on 1/5/24 to AD temperature was noted to be 112 degrees F.
Letter of Deficiency Citations Cleared provided to AD.
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Lissett PadgettTELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:
DATE: 01/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/08/2024
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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