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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107208981
Report Date: 09/27/2024
Date Signed: 10/21/2024 01:37:36 PM


Document Has Been Signed on 10/21/2024 01:37 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:OPOKU RESIDENTIAL CARE #2FACILITY NUMBER:
107208981
ADMINISTRATOR:OPOKU-ABABIO, KOFIFACILITY TYPE:
735
ADDRESS:679 E KEATS AVETELEPHONE:
(559) 475-4057
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY:4CENSUS: 4DATE:
09/27/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Kofi Opoku-AbabioTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Daiquiri Boyd arrived unannounced to conduct an annual visit. LPA introduced self, stated the purpose of the visit and granted entry by Staff. Staff then called Administrator, Kofi Opoku-Ababio so he could return to the home to complete the inspection. LPA toured facility with Administrator. Two clients were present at the beginning of the inspection, but left shortly after.

The tour started in the kitchen into the common areas, to the client's bedrooms, and bathrooms, garage, and backyard. The facility was observed to be at a comfortable temperature of degrees 72 degrees F and no passageway obstructions or fire hazards were observed inside or outside.
An adequate supply of perishable and non-perishable food was observed. Emergency food supply was available and in placed in the cabinets under the kitchen island. Cleaning supplies and chemicals stored and locked in a hall closet. First Aid checked and fully stocked.
Medications observed and kept locked in the dining area in a file cabinet.
All bedrooms were observed to have required bedding, lighting, furniture, and window covering. LPA observed four single occupant rooms.
Bathrooms contained hand soap and paper towels. Hot water temperature was tested at 114.4 degrees F.
Fire extinguisher was observed with a service date of 2/14/2024. Fire drill last completed on 08/29/24. Outside of facility toured and observed to be free of debris. Two gates exiting the backyard easily opened.
Outside area contained furnishings for clients to sit outside. Carbon monoxide and smoke detectors were tested and observed to be operational.
Staff file for staff #3 was missing documentation that the TB was completed. Client files were not missing any documentation. Administrator Certificate expires on December 31, 2024.
NO deficiencies were cited on this day.
Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by Administrator. Forms requested: LIC308, LIC 309, LIC 400, LIC 402, LIC 500, LIC 610D, LIC 9282, LIC 601, LIC 613C, consent form and control of property will be submitted by 09/19/2024 . A copy of this report was provided to the Licensee, whose signature on this form confirms receipt of this report.
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 243-8080
LICENSING EVALUATOR NAME: Daiquiri BoydTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:
DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/27/2024
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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