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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209080
Report Date: 09/21/2020
Date Signed: 09/28/2020 08:23:04 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:VICTORIA'S CARE HOMEFACILITY NUMBER:
107209080
ADMINISTRATOR:GITTI, JOSEPHFACILITY TYPE:
740
ADDRESS:5288 N. ROSALIA AVETELEPHONE:
(559) 960-3789
CITY:FRESNOSTATE: CAZIP CODE:
93723
CAPACITY:6CENSUS: 0DATE:
09/21/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Joseph Gitti- AdministratorTIME COMPLETED:
10:30 AM
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On this date, Licensing Program Analyst (LPA) D. Ayers conducted a Tele-visit with Administrator Joseph Gitti via FaceTime due to COVID-19 and precautionary measures. LPA introduced himself and stated the purpose of the inspection. The facility has fire clearance granted from the City of Fresno for 1 Bedridden and 5 Non-ambulatory residents. This facility is a Central Valley Regional Center(CVRC) vendor, and 2 of the 6 residents may be CVRC clients.

During virtual tour, LPA observed all passageways and exits to be clear and free from obstruction. The facility had a hard-wired sprinkler system and smoke detectors, and carbon-monoxide detector was observed. Fire extinguishers and first-aid kit observed by LPA. A locked cabinet was prepared for medications. Storage space was prepared for the keeping of confidential resident and staff documents. Sharp items and cleaning supplies were secured in locked drawers and cabinets. Resident bedrooms had required furnishings and were well lit. Resident bathrooms were clean and had secure grab bars and non-slip mats in the showers. Auditory alert devices and an integrated alarm system were installed on exterior doors and windows. Common areas were well lit and provide sufficient seating for 6 residents. The outdoor space was free from hazards, and the gate was secured with a self-latching door.

No deficiencies were observed during the inspection. A copy of this report was sent to Joseph via email.

SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: David AyersTELEPHONE: (559) 650-7925
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2020
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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