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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209044
Report Date: 04/19/2023
Date Signed: 04/20/2023 02:16:35 PM


Document Has Been Signed on 04/20/2023 02:16 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:GENIALCAREFACILITY NUMBER:
107209044
ADMINISTRATOR:FLAUTA, LYNETTEFACILITY TYPE:
740
ADDRESS:2374 LAS ROSAS AVETELEPHONE:
(209) 572-5157
CITY:CLOVISSTATE: CAZIP CODE:
93619
CAPACITY:6CENSUS: 5DATE:
04/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Administrator, Jill StowellTIME COMPLETED:
03:40 PM
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On 4/19/2023, Licensing Program Analyst (LPA) V Gorban arrived at the facility unannounced to conduct a required annual inspection. LPA met with Administrator Jill Stowell and announced the purpose of the visit.
LPA toured the facility inside and outside, back yard, one side of the facility had unlocked gate with easy access out in case of fire. The facility was at a comfortable temperature and all six bedrooms adequately furnished.
All passageways and exits were clear and free from obstruction. Facility had carbon monoxide and smoke detectors which were functioning. Facility fire extinguisher was serviced on 7/13/2022. The facility phone is functioning. LPA toured resident bedrooms and bathrooms. Bedrooms were adequately furnished and lit. Bathrooms were clean, odor free, and all fixtures were functioning properly.
LPA observed two-day supply of perishable food stuffs and seven-day supply of non-perishable food stuffs. Sharp items were secured in a locked drawer in the kitchen. Medications were locked in a cabinet in the kitchen and appear to be administered properly.
LPA reviewed Staff and Resident files. LPA reviewed staff and client files. LPA reviewed records of resident emergency preparedness plan.

Administrator agreed to provide LIC 500, LIC 308, LIC 9020 and LIC602 to CCLD by 5pm 4/26/2023.

No deficiencies were cited during the inspection. Exit interview conducted. A copy of the report was signed and provided to Administrator Jill Stowell.
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: Vadim GorbanTELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023
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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