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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107204023
Report Date: 02/14/2025
Date Signed: 02/14/2025 01:30:08 PM

Document Has Been Signed on 02/14/2025 01:30 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:ACCESS SPECIALIZED TREATMENT PROGRAMFACILITY NUMBER:
107204023
ADMINISTRATOR/
DIRECTOR:		KENDALL, RICHARDFACILITY TYPE:
775
ADDRESS:3433 WEST SHAW AVE. #101TELEPHONE:
(559) 225-6370
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY: 45CENSUS: 44DATE:
02/14/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:37 AM
MET WITH:Administrator, Katonya HuntTIME VISIT/
INSPECTION COMPLETED:
01:39 PM
NARRATIVE
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On 2/14/25 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA was met by Receptionist, Paulina Lopez explained reason for visit and was permitted entry into the facility. Administrator, Katonya Hunt was contacted and arrived some time later.

LPA completed a health and safety check on clients in care. 3 clients present during visit. All others were at a group outing. LPA toured the facility. Facility is one large room set up with stations clients go to. Clients present observed at station table. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 4/18/24. Last fire drill on 12/10/24. Water temperature measured at 118.6 degrees F in bathroom #1. Sharps, chemicals and medications were located in locked rooms. Facility does not have an outside area. Sample files for staff and clients reviewed.

The following issues were observed during todays visit: 1 of 3 staff files reviewed did not have the required health screening and TB. 1 of 3 client files reviewed do not have a complete admission agreement. 1 of 3 files reviewed has an outdated Needs and Service Plan. Facility does not have current version of the Disaster Plan with all required information. Deficiencies and TV's provided per Title 22. TSP (for files) was offered and declined.

LPA requested the following documents to be submitted to CCL by 2/21/25 : Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Affidavit regarding Resident Cash Resources (LIC 400), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file.

Exit interview completed with Administrator, Katonya. A copy of this report, deficiencies TV's and appeal rights provided.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2025
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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Document Has Been Signed on 02/14/2025 01:30 PM - It Cannot Be Edited


Created By: Mary Garza On 02/14/2025 at 01:02 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: ACCESS SPECIALIZED TREATMENT PROGRAM
FACILITY NUMBER: 107204023

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82066(a)(10)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator, and each employee. Each personnel record shall contain the following information: (10) A health screening, as specified in Section 82065(g).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation, the licensee did not comply with the section cited above in 1 of 3 personnel files were observed without a health screening with TB. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/21/2025
Plan of Correction
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Administrator stated that if they are unable to locate the health screening and TB the staff will be sent on Monday (2/17/25) to re-take/complete. Once completed Adminitrator stated they will send to CCL as proof of correction.
Type B
Section Cited
HSC
1565.5
Other Provisions
In addition to any other requirement of this chapter, an adult day program, as defined in Section 1502, shall have an emergency and disaster plan that includes, but is not limited to, all of the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation, the licensee did not comply with the section cited above in that the facility did not have the current version of the emergency disaster plan with all the required information. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/21/2025
Plan of Correction
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Administrator immediately printed new version of form. Administrator stated they will update the plan and send to CCL as proof of correction.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:See Moua
LICENSING EVALUATOR NAME:Mary Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2025


LIC809 (FAS) - (06/04)
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