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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157202539
Report Date: 12/13/2023
Date Signed: 12/13/2023 01:33:30 PM

Document Has Been Signed on 12/13/2023 01:33 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:POSITIVE PURPOSE, LLCFACILITY NUMBER:
157202539
ADMINISTRATOR:NIKKI COCKRENFACILITY TYPE:
735
ADDRESS:9008 STATEN ISLAND DRIVETELEPHONE:
(661) 847-9200
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 4CENSUS: 4DATE:
12/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Jamie Beckner, AdministratorTIME COMPLETED:
01:45 PM
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On 11/13/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit.
introduce self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with staff Amber Zaragoza. Administrator Jamie Beckner was called and arrived shortly. LPA toured facility with Administrator. Two clients were present upon LPA arrival. Clients left for outing with staff during inspection.

The facility was observed to be at a comfortable temperature of 76 degrees F, clean, in good repair, and no
passageway obstructions or fire hazards were observed inside or outside. Knives and cleaning chemicals were observed locked and accessible to clients under kitchen closet. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature observed maintained at 33 and freezer maintained at 0 degree F. Fire extinguisher was observed with a purchased date of: 11/06/23. Last fire drill completed on 11/26/23.

All bedrooms were observed to have the required furnishings and with adequate lightening. The bathroom was properly equipped and operating. Hot water temperature was tested at 114.8 in master bathroom, 118.9 in bathroom 1, and 116.4 in bathroom 2.

Outside of facility toured and observed to be free of debris. Side gate observed self-closing and self-latching. Outdoor seatings were observed available for clients. Carbon monoxide and smoke detectors were tested and observed to be operational. Medications observed kept locked in facility office. MARs were reviewed.
All clients and sample of staff files were reviewed to have all the required documents. Staff were fingerprinted cleared and associated to the facility. All clients cash resources reviewed.

No deficiencies issued during this inspection. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 12/19/23. Forms requested: Lic 308, Lic 500, and Lic 610D. A copy of this report was provided to Administrator whose signature on this form confirms receipt of this report.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2023
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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