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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107208857
Report Date: 10/16/2024
Date Signed: 10/28/2024 08:22:47 AM

Document Has Been Signed on 10/28/2024 08:22 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:AK'S HOME OF CARE LLCFACILITY NUMBER:
107208857
ADMINISTRATOR/
DIRECTOR:		MALHI, AKWANTFACILITY TYPE:
735
ADDRESS:122 W SAN GABRIEL AVETELEPHONE:
(559) 708-3485
CITY:CLOVISSTATE: CAZIP CODE:
93612
CAPACITY: 6CENSUS: 5DATE:
10/16/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Akwant MalhiTIME VISIT/
INSPECTION COMPLETED:
05:45 PM
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On 10/16/24 Licensing Program Analyst (LPA) Daiquiri Boyd arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection and met with staff, Sandeep Kaur and Administrator, Akwant Malhi.

LPA toured the inside and outside of the facility. The facility was observed to be at a comfortable temperature of 74 degrees F, clean, in good repair, and no passageway obstructions. An adequate supply of perishable and non-perishable food was observed. Cleaning supplies and chemicals are stored and locked in a cabinet outside the garage. Sharps and medications are kept in a locked cabinet in the living room. All bedrooms were observed to have required furnishings and with adequate lightening. LPA observed four bedrooms. Bathroom is properly equipped, and the hot water temperature was tested at 105.7 degrees F. Carbon monoxide and smoke detectors were tested and observed to be operational. A sample of staff and client’s files were reviewed. First Aid checked and fully stocked. Fire extinguisher purchased in August of 2024.

There were no deficiencies cited on this day. Exit interview was conducted.

The following updated forms are to be submitted to CCL by 10/25/24:

LIC308, LIC 309, LIC 400, LIC 402, LIC 500, LIC 610D, LIC 9282, LIC999, Administrator certificate, and control of property.

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Daiquiri Boyd
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2024
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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