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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107206335
Report Date: 08/30/2022
Date Signed: 08/30/2022 12:01:47 PM


Document Has Been Signed on 08/30/2022 12:01 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:ROYAL BOARD AND CARE FOR ELDERLYFACILITY NUMBER:
107206335
ADMINISTRATOR:RIGON, RUDYFACILITY TYPE:
740
ADDRESS:3407 N. FRESNOTELEPHONE:
(559) 903-6846
CITY:FRESNOSTATE: CAZIP CODE:
93726
CAPACITY:6CENSUS: 0DATE:
08/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Aurora RigonTIME COMPLETED:
11:11 AM
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Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Inspection Visit. LPA Medina met with Administrator, Aurora Rigon, and discussed the purpose of the visit.

There are currently no residents in care. Per Administrator, the facility has been without residents for 2 months.

LPA Medina toured facility and observed a visitor/temperature log, masks, and disinfection station at the front entrance. Facility has one entry and exit point. Covid-19 related signs were observed in the common areas. There are no personal belongings in any of the resident bedrooms.

LPA Medina observed carbon monoxide detector and smoke detectors to be operational during facility inspection. Fire extinguisher present with a purchase date of 2/15/22.

Administrator to notify Fresno CCL office upon decision of continuing to operate or surrendering license to department.

No deficiencies were observed.

Exit interview was conducted and a copy of this report was provided.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 08/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/30/2022
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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