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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203993
Report Date: 07/22/2024
Date Signed: 07/22/2024 10:52:57 AM

Document Has Been Signed on 07/22/2024 10:52 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:ROSAMOND RESIDENTIAL HOME AT SCHERER DRIVEFACILITY NUMBER:
157203993
ADMINISTRATOR/
DIRECTOR:
HARDGE, A. TERRENCEFACILITY TYPE:
735
ADDRESS:3833 SCHERER DRIVETELEPHONE:
(661) 256-4413
CITY:ROSAMONDSTATE: CAZIP CODE:
93560
CAPACITY: 6CENSUS: 4DATE:
07/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:05 AM
MET WITH:Administrator Terrence Hardge TIME VISIT/
INSPECTION COMPLETED:
10:53 AM
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On 07/22/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct subsequent Annual inspection. LPA met with Administrator Terrance Hardge. LPA toured facility with Administrator. No client present during inspection.


The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. An adequate supply of perishable and non-perishable food was observed. Medications observed kept locked in kitchen shelf. Medication were audits and MARs were reviewed. Temperature maintained for refrigerator at 39 degrees F and freezer at 0 degrees F. Fire extinguisher was observed with a service date of: 09/29/23. Bathrooms were observed operational. Hot water temperature was tested at 106.3 degrees F in bathroom 1 and range between 106.9 and 108.2 in master bathroom. Outside of facility toured and observed to be free of debris. Side gate observed self-closing. All client and sample of staff files reviewed to have all required documents.

No deficiencies issued during this inspection.

Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 7/28/24. Forms requested: Lic 308, Lic 500, Lic 610D, and current Administrator Certificate. 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: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/22/2024
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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