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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203492
Report Date: 10/07/2024
Date Signed: 10/07/2024 11:47:44 AM

Document Has Been Signed on 10/07/2024 11:47 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:MOUNTAIN PATHWAYSFACILITY NUMBER:
157203492
ADMINISTRATOR/
DIRECTOR:
SOTO, AMYFACILITY TYPE:
775
ADDRESS:311 WEST F STREETTELEPHONE:
(661) 823-7302
CITY:TEHACHAPISTATE: CAZIP CODE:
93561
CAPACITY: 40CENSUS: 36DATE:
10/07/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Victor Silva, Program ManagerTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 10/07/24, Licensing Program Analyst (LPA) M. Yang conducted required Annual Inspection. LPA introduced self, stated the purpose of the visit and requested to meet with Administrator. LPA met with Program Manager Victor Silva who stated is the current Administrator. There were 27 clients were present during the inspection. Clients were observed in activity rooms.

LPA toured facility and observed activity rooms: front, middle, kitchen, big, and isolation room. All activity areas were clean, odor free, and at comfortable temperature.

All passageways and exits were clear and free from obstruction. Fire extinguisher was observed throughout the facility with serviced date: 08/16/24. Last fire drill completed on 09/18/24. Cleaning supplies were observed locked in supply room. All client’s restrooms were tour, observed to be clean, and operational. Hot water was tested at 109.8 degrees F in bathroom 1, 110.7 degree F in bathroom 2, and 110.1 degrees F in bathroom 3. Facility washer and dryer observed in the back of facility by the kitchen.



Client brings their own lunches and cold lunches was observed stored in refrigerator. Client locked lockers were observed. Outside was toured and observed to be free of obstruction. Outdoor seatings were observed available for clients.

LPA observed locked medications in Program Manager office. MARs were reviewed. A sample of client and staff files were also reviewed to have all the required documents. Carbon monoxide and smoke detector observed operational in every room.

No deficiencies were observed.

Exit Interview conducted. The following documents are requested and to be submitted to Fresno CCL by: 10/14/24. The following updated forms were requested: Lic 308, Lic 500, Lic 610D, Lic 9020, and control of property. A copy of this report was provided to the Program Manager, whose signature confirms receipt of this report.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2024
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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