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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107204054
Report Date: 07/12/2024
Date Signed: 07/12/2024 02:56:40 PM


Document Has Been Signed on 07/12/2024 02:56 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:HAPPY LIVING FACILITYFACILITY NUMBER:
107204054
ADMINISTRATOR:CATACUTAN, RAQUELFACILITY TYPE:
740
ADDRESS:5275 E. KAVILANDTELEPHONE:
(559) 228-9342
CITY:FRESNOSTATE: CAZIP CODE:
93725
CAPACITY:6CENSUS: 2DATE:
07/12/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Licensee/Administrator (L/A) Raquel CatacutanTIME COMPLETED:
03:15 PM
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An Informal Office Meeting was conducted on this date to discuss concerns at the facility. Present during the meeting were:

Regional Manager, Brenda White
Licensing Program Manager, See Moua
Licensing Program Analyst, Kelly McClurg
Licensee and Administrator, Raquel Catacutan

The following issues were discussed:
-Licensee Raquel’s intention regarding the continued operation of the facility.
-The deficiencies and civil penalties issued during the Annual continuation visit conducted on 5/14/24 regarding:
*Fire Safety – resident’s bed obstructed entry and exit way of the bedroom
*Accessibility of unlocked storage spaces that contained hazardous items such as aerosol brake cleaner, motor oil, trimmer, gasoline, motor oil, and knives
*Unlocked medications in the resident’s bedroom
*Maintenance and Operations - Missing toilet seat in the resident’s bathroom, uncleaned living areas, and clutter
*Food Service Requirements – refrigerator unable to maintain proper temperature and food improperly stored
-The Health & Safety visit conducted on 10/19/2023
*Citations and civil penalties of $1000.00 were issued because residents were left with no supervision and the front door was locked with a chain lock that was at the highest point of the door, inaccessible to the residents
-Staffing and care and supervision of the residents


Exit interview was conducted at the conclusion of the meeting. Report provided.
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) 580-4596
LICENSING EVALUATOR NAME: Kelly J. McClurgTELEPHONE: (559) 246-0435
LICENSING EVALUATOR SIGNATURE:
DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/12/2024
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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