157202387-7-8-2025-24-AS-RABE-DJ5U3S-20250630151401

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 157202387
Report Date: 06/30/2025
Date Signed: 07/08/2025 08:26:33 AM

Document Has Been Signed on 07/08/2025 08:26 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:	MOUNTAIN VIEW RANCH RES. CARE		FACILITY NUMBER:	157202387
ADMINISTRATOR/ DIRECTOR:	NANKIL, PATRICK R.		FACILITY TYPE:	735
ADDRESS:	3046 HINSLEY ST		TELEPHONE:	(661) 374-4265
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93307
CAPACITY: 4		CENSUS: 4	DATE:	06/30/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:15 PM
MET WITH:	Patrick Nankil, Administrator		TIME VISIT/ INSPECTION COMPLETED:	03:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On June 30, 2025, Licensing Program Analyst (LPA) Rachel Bruce arrived at this facility unannounced to conduct annual inspection. LPA introduced herself and purpose of the visit and was granted entry by staff Cesar DeLaRosa, Direct Service Provider (DSP). DSP called Administrator Patrick Nankil (AD) who arrived to facility shortly thereafter Upon arrival one resident was present, 1 other returned during the visit. Kitchen: LPA observed that the kitchen was well maintained, clean counters, floors that are free from debris and well maintained appliances. The knives are kept in a locked drawer and LPA observed sufficient amount of dishes and flatware for 6 residents. Kitchen had a trash can with a lid. LPA observed the refrigerator well stocked, appropriate temperature measurements, well maintained and clean. The kitchen cabinets are clean, and organized. LPA observed 7 days of non-perishable food an 2 days of perishable food. All food clearly labeled and stored appropriately. No expired food was observed. There is a pantry in the kitchen and a carry over freezer and refrigerator in the garage. LPA observed medication cabinet has designated section for each resident, labeled and organized. First aid kit was inspected and found to contain the required items. LPA observed the dining room is well lit and clean. Dining table has seating for 3 with space for client with wheelchair. Carbon monoxide detector was tested and found to be functioning. Non functioning fireplace in living room. Living area had television, sofas and comfortable seating able to accommodate at least 6 people. The living room has a door that leads to the backyard. The interconnected smoke/carbon monoxide detectors were tested by staff and found to be functioning. A fire extinguisher stored in entry closet and was purchased in 10/2024, with the correct pressure gauge as indicated on the meter.

NAME OF LICENSING PROGRAM MANAGER: Sergiy Pidgirny
NAME OF LICENSING PROGRAM ANALYST: Rachel A Bruce
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/30/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: MOUNTAIN VIEW RANCH RES. CARE	FACILITY NUMBER: 157202387
	VISIT DATE: 06/30/2025

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LPA inspected the staff bathroom and observed that the bathroom is well maintained, well lit, toilet paper, hand soap, a trash bin with lid. LPA observed the linen closet in the staff restroom to have sufficient number of clean towels, linens, and blankets. Laundry room is kept locked; has washer and dryer, cleaning supplies are stored in the cabinets.

LPA observed that the garage is well maintained, free from obstructions and debris. The garage has locked storage cabinets for extra toiletries, cleaning supplies and air fresheners. Extra Refrigerator and freezer contained extra meat and food.

This facility has 5 bedrooms. 4 are occupied by the residents and 1 bedroom is allocated for Staff. All resident bedrooms have their own restroom and shower. All had appropriate cabinets to store toiletries, grab bars, and non- slip mats in the shower areas. All toilets were functioning, bathrooms had good lighting and temperature of hot water was within regulatory ranges. Bedrooms all contained required furniture, adequate closet space to store clothing and belongings. Furniture and linens are free from stains and are well maintained. Windows and screens in good condition except one bedroom has missing screen which will be replaced today.

LPA with AD inspected the back and front yard which are both well maintained. Patio chairs and table are located in the front area which is shaded and is the place residents tend to recreate and hang out. There is space in the back yard as well with a few chairs available. There is property which is appropriately fenced off and there are goats and dogs that are the responsibility of the facility. The exterior walkways are free from obstructions and debris.

LPA reviewed residents and staff records with AD and found that all documents are in order and up to date. . No citations issues at today's inspection.

LPA is requesting the following documents be submitted to the Fresno CCL office by 7/10/2025. Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610D) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond.

NAME OF LICENSING PROGRAM MANAGER: Sergiy Pidgirny
NAME OF LICENSING PROGRAM ANALYST: Rachel A Bruce
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/30/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2025

LIC809 (FAS) - (06/04)

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