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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209444
Report Date: 07/17/2024
Date Signed: 07/17/2024 11:16:29 AM

Document Has Been Signed on 07/17/2024 11:16 AM - 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: 0DATE:
07/17/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Ray Gilbert, ApplicantTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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LPA Lissett Padgett arrived to conduct a follow-up Prelicensing visit. LPA was granted entry by Ray Gilbert.
LPA enter building 835 and tested the water temperature. Water temperature was found to be 118.0 in bathroom 1 and 115.7 in bathroom 2. Pre-Licensing deficiencies have been resolved. Pre-Licensing is now complete.
Component III conducted during this visit. Exit interview conducted. Copy of this report was emailed to applicants.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Lissett Padgett
LICENSING EVALUATOR SIGNATURE: DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2024
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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