<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107204054
Report Date: 05/16/2025
Date Signed: 05/16/2025 09:16:12 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 05/16/2025 09:16 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/
DIRECTOR:		CATACUTAN, RAQUELFACILITY TYPE:
740
ADDRESS:275 E KAVILANDTELEPHONE:
(559) 228-9342
CITY:FRESNOSTATE: CAZIP CODE:
93725
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
05/16/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:45 PM
MET WITH:Licensee/Administrator (L/A) Raquel CatacutanTIME VISIT/
INSPECTION COMPLETED:
09:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
An unannounced Annual Continuation visit was conducted the date & times indicated above by Licensing Program Analyst (LPA) K. McClurg. The purpose of this visit was to continue Annual visit conducted on 4/29/25. LPA met with Licensee/Administrator (L/A) Raquel Catacutan.

During previous visit on 4/29/25 a physical plant tour was conducted where it was observed that facility did not have an operational carbon monoxide detector. Access to side yard was denied @ time of that visit. Centrally Stored Medication & Destruction Records (CSMDR) were observed to not be maintained. Records did not reflect all medications on premises.

LPA had been contacted 4/30/25 with photos of installed carbon monoxide detector. It was observed during today's visit (5/16/25) that 1 carbon monoxide detector observed in kitchen/dining/living area & 1 installed in hallway with client bedrooms. CSMDRs reviewed with current updates & corrections. Citations for carbon monoxide detector absence & CSMDR not being maintained issued & cleared during today's visit.

Citation regarding denial of access to side yard to be reviewed at the Fresno Regional Office at a future date .

Exit interview conducted with L/A. Report provided.
See MouaTELEPHONE: (559) 580-4596
Kelly J. McClurgTELEPHONE: (559) 246-0435
DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 3
Document Has Been Signed on 05/16/2025 09:16 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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


FACILITY NAME: HAPPY LIVING FACILITY
FACILITY NUMBER: 107204054

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/30/2025
Section Cited
HSC
1503.2

1
2
3
4
5
6
7
Every facility… pursuant to this chapter shall have one or more carbon monoxide detectors in the facility that meet…standards…
§1503.2 Carbon monoxide detectors required…
During 4/29/15 visit it was observed that this facility did not have an operational carbon monoxide detector.
1
2
3
4
5
6
7
DEFICIENCY CLEARED
Carbon monoxide detectors installed 4/30/25. LPA was notified of installation. Photos provided with notification. Correction verified as observed during 5/16/25 visit.
Type A
04/30/2025
Section Cited
CCR
80075(k)(7)

1
2
3
4
5
6
7
80075(k)(7) Health Related Services The licensee shall ensure the maintenance, for each client, of a record of centrally stored prescription medications…
CSMDR observed to be incomplete & not maintained as required.
1
2
3
4
5
6
7
DEFICIENCY CLEARED
CSMDRs reviewed reflecting updates & corrections to record.
Type A
04/29/2025
Section Cited
CCR80044(a)

1
2
3
4
5
6
7
80044(a) Inspection Authority of the Licensing Agency. The licensing agency shall have inspection authority…
During 4/29/25 Annual LPA’s K. McClurg & J. Leffal were denied access to side yard with motorhome.
1
2
3
4
5
6
7
This will be reviewed at the Fresno Regional Office at a later date.

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
See MouaTELEPHONE: (559) 580-4596
Kelly J. McClurgTELEPHONE: (559) 246-0435

DATE: 05/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2025

LIC809 (FAS) - (06/04)
Page: 3 of 3