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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203167
Report Date: 12/16/2024
Date Signed: 12/16/2024 07:40:41 PM

Document Has Been Signed on 12/16/2024 07:40 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:		ORTIZ,MARIA ALICIAFACILITY TYPE:
735
ADDRESS:777 MASTTELEPHONE:
(661) 721-3525
CITY:MCFARLANDSTATE: CAZIP CODE:
93250
CAPACITY: 4CENSUS: 3DATE:
12/16/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
05:45 PM
MET WITH:Administrator Alicia Maria OrtizTIME VISIT/
INSPECTION COMPLETED:
08:00 PM
NARRATIVE
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On 12/16/2024, Licensing Program Analysts (LPAs) K.Kaur and L. Salazar arrived unannounced and conducted a case management - deficiencies in conjunction with a subsequent complaint visit. LPAs met with Administrator Alicia Maria Ortiz and explained the purpose of the visit.

During file review LPAs observed 2 (R1 & R2) out of 3 residents are above 60 and the facility does not have an approved exception request. LPAs reviewed the Acceptance and Retention Limitations with the Administrator and submitted information via email. LPAs observed medical assessment had the required information for an Adult Resident instead of elderly. Medical Assessment, Physician’s Report LIC602 was dated 8/15/2021.

Deficiencies are being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6.

An exit interview was conducted with Licensee. POC were developed and reviewed. Report signed on-site by Administrator and printed copy was provided with appeal rights.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kamaldeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2024
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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Document Has Been Signed on 12/16/2024 07:40 PM - It Cannot Be Edited


Created By: Kamaldeep Kaur On 12/16/2024 at 07:11 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: POSITIVE DIRECTIONS #7
FACILITY NUMBER: 157203167

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/17/2024
Section Cited
CCR
85068.4(g)

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85068.4 Acceptance and Retention Limitations
(g) If acceptance or retention of an individual 60 years of age or older would result in the number of persons 60 years of age or older exceeding 50 percent of the census in facilities with a capacity of six or fewer clients... the licensee must request an exception in order to accept or retain the individual. The exception request must be made in accordance with Section 80024.

This requirement is not met as evidenced by:
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Administrator agrees to submit a exception request by due date.
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During file review LPAs observed 2 (R1 & R2) out of 3 residents are above 60 and the facility does not have an approved exception request
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Type A
12/17/2024
Section Cited
CCR85068.4(e)

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85068.4 Acceptance and Retention Limitations
(e) The licensee shall ensure that the medical assessment for each client 60 years of age or older is updated at least annually and in accordance with the regulations addressing medical assessments in Residential Care Facilities for the Elderly (RCFE) [California Code of Regulations, Title 22, Sections 87458(b) and (c)].

This requirement is not met as evidenced by:
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Administrator agrees to schedule Doctors appointments by due date and send information to CCLD. Once Medical Assessments are obtained, they will be forwarded to LPA.
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LPAs observed during file review Medical Assessment, Physician’s Report LIC602 for R1 was dated 8/15/2021.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:See Moua
LICENSING EVALUATOR NAME:Kamaldeep Kaur
LICENSING EVALUATOR SIGNATURE:
DATE: 12/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/16/2024


LIC809 (FAS) - (06/04)
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