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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209444
Report Date: 06/28/2024
Date Signed: 06/28/2024 12:02:38 PM

Document Has Been Signed on 06/28/2024 12:02 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:HELPING HANDS SENIOR CAREFACILITY NUMBER:
107209444
ADMINISTRATOR/
DIRECTOR:		NGUYEN, ELSAFACILITY TYPE:
740
ADDRESS:825 S WILLOW AVENUETELEPHONE:
(650) 776-2280
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 30CENSUS: DATE:
06/28/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Ray Gilbert, ApplicantTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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Licensing Program Analyst Lissett Padgett arrived conducted an announced Pre-Licensing continuation inspection. LPA met with applicant Ray Gilbert (RG). Facility was toured with RG.
LPA observed the following issues noted on the 6/18/2024 inspection have been corrected:

1. Trash can with lid in all bathrooms and in kitchens- observed to be in compliance in each bulding
2. Designated centrally stored medication cabinet installed in each resident building- observed to be in compliance
3. Install a lock on shed located at building 4 which stores paint supplies and chemicals - LPA observed combination lock installed
3. Signal system to be installed in each resident building- all residents will have signal necklace - when pressed number is shown
4. Install lock on cabinet that will store chemicals and knives/sharps- LPA observed lock installed under each kitchen sink cabinet.
5. Lower water temperature within the 105-120 degree F range- LPA rechecked bathroom sink water temperatures in each building, the following are the results:
Building 825:113.5 degrees F, 112.5 degrees F
Building 841: 114.4 degrees F, 114.1 degrees F
Building 853: 114.4 degrees F, 114.1 degrees F
Building 865: 114.8 degrees F, 114.3 degrees F
Building 877: 115.3 degrees F, 117.3 degrees F

continued on LIC809-C
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Lissett Padgett
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2024
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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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: HELPING HANDS SENIOR CARE
FACILITY NUMBER: 107209444
VISIT DATE: 06/28/2024
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6. Clean shower and floors in building 5- LPA observed this has been cleaned.
7. Install grab bar near toilet in building 5- observed grab bar has been installed
8. Install screen in bedroom window in building 5- observed screen has been installed.
9. Emergency lighting (e.g. flashlights) to be placed in each building- observed to be in compliance
10. Required postings in each building- observed to be in compliance
11. remove fencing materials from the perimeter of grounds- observed to be in compliance
12. Thermometers for refrigerator and freezer- observed to be in compliance

LPA observed the water temperature in Building 835 to be at 80 degrees F and 86 degrees F and will need to be brought into compliance prior to licensure. RG will contact this LPA when ready for reinspection.

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Lissett Padgett
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2024
LIC809 (FAS) - (06/04)
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