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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203167
Report Date: 09/11/2024
Date Signed: 09/11/2024 02:03:31 PM

Document Has Been Signed on 09/11/2024 02:03 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 DIRECTIONS #7FACILITY NUMBER:
157203167
ADMINISTRATOR/
DIRECTOR:		HOBBES, ANNFACILITY TYPE:
735
ADDRESS:777 MASTTELEPHONE:
(661) 721-3525
CITY:MCFARLANDSTATE: CAZIP CODE:
93250
CAPACITY: 4CENSUS: 3DATE:
09/11/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Staff Juanita RodriguezTIME VISIT/
INSPECTION COMPLETED:
02:20 PM
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On 9/11/2024, Licensing Program Analyst (LPA) K.Kaur arrived unannounced and conducted a case management - deficiencies in conjunction with a subsequent complaint visit.

LPA observed during review of resident’s documents. R1 did not have a medical assessment on file. Administrator was unreachable and staff could not locate/ find records of assessment. Staff contacted several staff to determine who would know of such records. After some time Staff was able to contact day program to obtain copies of the Physicians Report (LIC 602) and results of TB Clearance. LPA recommended the facility to complete a Designation of Facility Responsibility (LIC308) to avoid similar incidents. No deficiency was cited.

An exit interview was conducted with Staff Juanita Rodriguez. Report signed on-site by staff and printed copy provided with appeal rights.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kamaldeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 09/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/11/2024
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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