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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157200680
Report Date: 06/24/2024
Date Signed: 06/24/2024 12:45:59 PM

Document Has Been Signed on 06/24/2024 12:45 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:PATHWAYSFACILITY NUMBER:
157200680
ADMINISTRATOR/
DIRECTOR:
STOCKTON, MELISSAFACILITY TYPE:
775
ADDRESS:1401 POSO AVENUETELEPHONE:
(661) 758-5331
CITY:WASCOSTATE: CAZIP CODE:
93280
CAPACITY: 90CENSUS: 47DATE:
06/24/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:38 AM
MET WITH:Program Manager Irais Mejia TIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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On 06/24/2024, Licensing Program Analyst (LPA) K.Kaur arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and met Program Manager Irais Mejia

LPA toured the facility inside and outside. All passageways and exits were clear and free from obstruction. Facility was at a comfortable temperature and well lit. All classrooms and activity areas were clean and odor free. Bathrooms were clean and fixtures were functioning properly. LPA observed multiple first-aid kits throughout the facility.

Program Participants were observed participating in group activities with assigned instructors providing care and supervision. Client medication was locked and stored in the med room. Medication and Centrally Stored logs were reviewed. The day program grounds are clean and in good repair. Disinfectants and cleaning supplies were locked and inaccessible to clients in two storage rooms. Emergency procedures are in place, PPE is available if needed. Outside was toured, seating and shaded areas are available. Doors and passageways are unobstructed throughout the program. Fire Extinguishers dated 2/27/2024. Smoke and Carbon Monoxide detectors present and inspected annually by the fire department. LPA conducted client and staff file reviews and interviews. Clients bring their own lunches to program. Lunches stored in two refrigerators in facility kitchen. Last Fire drill conducted March 25, 2024. Next fire drill scheduled for this month. Client and staff files were reviewed and had all necessary documents.

No deficiencies were observed.

An exit interview was conducted. The following documents are requested and need to be submitted to Fresno CCL by 7/01/24. Designation of Facility Responsibility LIC308, Administrator Organization LIC309, Personnel Report LIC500, Emergency and Disaster Plan LIC610D, and Register of Facility Clients LIC9020. Report signed on-site by Manager and a printed copy was provided.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kamaldeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 06/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2024
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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