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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107208930
Report Date: 12/23/2024
Date Signed: 12/23/2024 01:47:14 PM

Document Has Been Signed on 12/23/2024 01:47 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
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:WINDHAM, THEFACILITY NUMBER:
107208930
ADMINISTRATOR/
DIRECTOR:		EARLEY, JOHNFACILITY TYPE:
740
ADDRESS:1100 E SPRUCE AVETELEPHONE:
(559) 449-8070
CITY:FRESNOSTATE: CAZIP CODE:
93720
CAPACITY: 88TOTAL ENROLLED CHILDREN: 0CENSUS: 79DATE:
12/23/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:28 AM
MET WITH:Administrator John EarleyTIME VISIT/
INSPECTION COMPLETED:
02:00 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 Informal Meeting was held via Teams on 12/23/2024. The purpose of the office meeting was to discuss recently identified issues associated with the operation of the facility.

The informal conference process was explained during the meeting.

The following were in attendance:
CCLD
Brenda Chan – Licensing Program Manager
Martin Vega – Licensing Program Analyst

The Windham
John Earley – Executive Director / Administrator
Leticia Higares – Regional VP of Operations
Nancy Pultz – Health and Wellness Director
Kimberly Eldridge – Regional Health and Wellness Director

During this meeting the following issues were brought to the attention of the licensee:
Type A 11/22/24 Section Cited CCR 87705 - Care of Persons with Dementia
Type A 04/03/24 Section Cited CCR 87465 - Incidental Medical and Dental Care

Licensee has agreed to provide a Plan of Action, describing how to maintain the health and safety of facility residents, to CCLD by 12/27/2024.

Continued on LIC 809C
Brenda ChanTELEPHONE: (650) 272-4781
Martin VegaTELEPHONE: 559-243-8080
DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/23/2024
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 2
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: WINDHAM, THE
FACILITY NUMBER: 107208930
VISIT DATE: 12/23/2024
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
26
27
28
29
30
31
32
The Administrator agreed to do the following:
Executive Director (ED) stated that will update medical forms for residents. All facility staff will be trained in appropriate management of residents that present wondering tendencies and Dementia Diagnoses. ED stated that implemented training to staff regarding medication distribution to residents.


An exit interview was conducted, and a copy of this report dated was given to ED on 12/23/2024, Licensing Program Manger Brenda Chan offered Executive Director John, information about Technical Support Program: https://cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/technical-support-program. ED stated that facility will not need TSP service at this time.
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 272-4781
LICENSING EVALUATOR NAME: Martin VegaTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2