107206752-5-24-2024-24-AS-LPAT-D5KL39-20240524082332

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 107206752
Report Date: 05/22/2024
Date Signed: 05/24/2024 08:30:01 AM

Document Has Been Signed on 05/24/2024 08:30 AM - 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:	DIAL FOR CARE		FACILITY NUMBER:	107206752
ADMINISTRATOR:	RAMIZ ALCHI		FACILITY TYPE:	740
ADDRESS:	1594 E. LOS ALTOS		TELEPHONE:	(559) 878-3069
CITY:	FRESNO	STATE: CA	ZIP CODE:	93710
CAPACITY:	6	CENSUS: 4	DATE:	05/22/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Ramiz Alchi, Administrator		TIME COMPLETED:	01:40 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	Licensing Program Analyst L. Padgett (LPA) , conducted an unannounced annual visit to the facility and met with Administrator (AD) Ramiz Alchi and House Manager Shameka Turner (HM). LPA stated the purpose of the visit and was accompanied by HM while conducting the inspection of the facility. At the time of the visit, LPA observed 2 residents in the facility. LPA observed that the kitchen was well maintained, with working lights and well maintained appliances. The knives were kept in a locked cabinet not easily accessible. The kitchen counters and sink are free from debris. LPA observed that refrigerator, was kept at a 40 degree F, and the freezer at 0 degree F, well maintained and clean. LPA observed a 2 day perishable food supply. The kitchen pantry was clean, organized, and had 7 days of non-perishable food. No expired food was observed. A fire extinguisher is mounted on the wall and inspected on 5/15/2024 with the correct pressure gauge as indicated on the meter. LPA observed the dining room is well lit. Dining table has seating for 4. Activity calendar is displayed in entryway. LPA observed that the garage is well maintained, free from obstructions, and debris. The garage has storage cabinets for extra linens and incontinence supplies. HM unlocked and opened the storage cabinets. LPA observed the storage cabinets to contain cleaning supplies. In Laundry room LPA observed washer and dryer, Medications are kept in locked cabinet. AD opened the medication cabinet for inspection. Resident medication bins are individually labeled and organized. First aid kit was inspected and found to contain the required items. LPA observed the living room has non-operational fireplace. Television was observed to be in a secure place. LPA observed 2 sofas and 1 recliner. The living room can accommodate at least 6 people. The living

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Lissett Padgett	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: DIAL FOR CARE	FACILITY NUMBER: 107206752
	VISIT DATE: 05/22/2024

NARRATIVE

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room has a sliding glass door that was clean and not obstructed. The furniture was clean and in good condition.
In the hallway that leads to the bedrooms, LPA observed smoke/ carbon monoxide detector installed. The smoke alarm and carbon monoxide detectors were tested by the HM and are functioning. Detectors are interconnected and sounded from rooms..

LPA inspected the hallway bathroom and observed that the bathroom is well maintained, well lit, toilet paper, hand soap, a trash bin with lid. Water temperature measured at 114.6 degrees F. The bathroom was observed to have grab bars in shower, grip bar next to toilet, shower, bench. The toilet was flushed and is functioning. LPA observed the linen closet next to the bathroom have clean towels and linens. Towels are color coded for each resident and organized.

LPA inspected the 4 resident bedrooms with AD. LPA observed bedrooms are not shared. The bedrooms are well lit, the furniture is in good condition, the linens are in good condition. Windows open and screens are in good condition.

Bedroom 2 has a private bathroom with covered trash bin, shelves for toiletries, grab bars, non-skid floor and a shower bench. AD flushed the toilet and it was found to bee in working properly. The water temperature measured at 115.9 degrees F.

LPA with HM inspected the backyard. LPA, observed that the backyard is well maintained, trees, bushes and grass in good condition. Two patio tables and 9 chairs are under a covered patio, furniture is clean and ready for use. The exterior walkways are free from obstructions and debris.

LPA reviewed residents and staff records with AD and found that all documents are in order and up to date.

An exit interview was conducted with AD. A copy of the signed report and appeals rights were provided.

LPA is requesting the following documents be submitted to the Fresno CCL office by 5/31/2024: Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610D) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond.

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Lissett Padgett	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024

LIC809 (FAS) - (06/04)

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