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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107208983
Report Date: 02/09/2023
Date Signed: 02/14/2023 02:54:17 PM


Document Has Been Signed on 02/14/2023 02:54 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:SUMMERFIELD OF FRESNOFACILITY NUMBER:
107208983
ADMINISTRATOR:FOWLER, JENNIFERFACILITY TYPE:
740
ADDRESS:6075 N. MARKSTELEPHONE:
(559) 446-6226
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY:64CENSUS: 29DATE:
02/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:04 PM
MET WITH:Executtive Director, Beronica GalindoTIME COMPLETED:
01:50 PM
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On 2/9/2023 Licensing Program Analyst (LPA) M. Garza arrived unannounced to completed an Infection Control/Annual visit. LPA was COVID pre-screened at entry and met with Executive Director, Beronica Galindo. LPA discussed reason for visit and was permitted entry into facility. LPA completed tour of facility with Beronica and completed a health and safety check on residents in care. Residents observed in common areas and in rooms..

Required postings were observed. Furniture in common areas are spaced to promote physical distancing. A supply of PPE is located in the storage closet in the hallway. The 30 day supply of medication is located in the Medication Technician Room and in medication carts. All required postings observed throughout the facility. However, no hand washing postings observed at hand washing stations.

Fire Extinguisher last serviced 9/22/22. LPA requested the following updated forms by 2/16/23: LIC 308, LIC 309, LIC 500, LIC 610D, and LIC 9020.

No deficiencies cited during todays visit. Exit interview completed with Executive Director, Belinda Galindo. A copy of this report was given.
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -580-4596
LICENSING EVALUATOR NAME: Mary GarzaTELEPHONE: 559-365-9009
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2023
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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