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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206689
Report Date: 09/25/2026
Date Signed: 09/25/2026 03:38:30 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 09/25/2026 03:38 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
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:A COMFORT CARE HOMEFACILITY NUMBER:
157206689
ADMINISTRATOR/
DIRECTOR:		SCHISSLER, EVANGELINE T.FACILITY TYPE:
740
ADDRESS:12409 ANDES AVETELEPHONE:
(661) 679-7494
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY: 6CENSUS: 5DATE:
09/25/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:10 AM
MET WITH:Evangeline SchisslerTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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On 9/25/2026, Licensing Program Analysts (LPAs) M. Medina and J. Duarte conducted an unannounced Annual Required Inspection. LPAs arrived, introduced self, stated purpose of visit, and allowed entrance by direct care staff. Licensee/Administrator Evangeline Schissler contacted by telephone and arrived a short time later to conduct visit with LPAs.

LPAs observed facility to be clean, odor free, and temperature to be 79 degrees. Facility observed to be equipped with auditory alarms on all exit doors; however, not in the "on" position. Resident rooms toured, LPA observed medications dispensed in cups in resident 2 (R2's) bedroom. All common areas observed to have adequate seating available for residents. Bathrooms observed to have grab bars, shower chairs, and non-skid mats available. Fixtures in the bathroom observed to be functional. Water temperature measured at 111 degrees F. Kitchen toured, facility has a 7-day supply of non-perishable food and a 2-day supply of perishable food available. LPAs observed food in refrigerator to be stored and not dated. LPAs also observed canned food in pantry beyond expiration date. LPA observed medications in kitchen cabinet and in enclosed hallway passageway to garage, area is unlocked and accessible to residents. Medications cabinets observed to be unlocked and unsecured during inspection. LPAs observed during file review that all resident did not have a centrally stored medication records.

LPAs observed smoke detectors and carbon monoxide detectors to be operational during facility inspection. Fire extinguisher present with a purchase date of 7/29/2026.

Outside of facility toured. Pool is surrounded with a 5 foot wrought iron fence, observed to be locked, secured, and inaccessible to residents. Shed in backyard was unlocked and contained chemicals for the pool and hazardous equipment. LPAs observed a bed headboard in the backyard near the pool and miscellaneous items along the North side of facility that needed to be moved and secured or disposed of.

Continued on 809-C
See Moua
Melinda Medina
DATE: 09/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: A COMFORT CARE HOME
FACILITY NUMBER: 157206689
VISIT DATE: 09/25/2026
NARRATIVE
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LPAs reviewed staff and resident files. During file review and review of fingerprint clearance, LPA observed that staff 2 (S2) is fingerprint cleared and not associated to facility and was working alone at start of inspection. S2 did not have current CPR or first aid training on file.

Deficiencies are being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 9099D. An immediate Civil Penalty is being Assessed on the attached LIC421M.

Exit interview conducted. A copy of signed report and Appeal rights will be emailed to licensee.
NAME OF LICENSING PROGRAM MANAGER: See Moua
NAME OF LICENSING PROGRAM ANALYST: Melinda Medina
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2026
LIC809 (FAS) - (06/04)
Page: 6 of 6
Document Has Been Signed on 09/25/2026 03:38 PM - It Cannot Be Edited


Created By: Melinda Medina On 09/25/2026 at 12:49 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: A COMFORT CARE HOME
FACILITY NUMBER: 157206689

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/26/2026
Section Cited
CCR
87355(e)(3)

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(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or
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Licensee to submit LIC9182 to Fresno Regional office to associate S2 fingerprint clearance to facility.

IMMEDIATE CIVIL PENALTY ASSESSED IN THE AMOUNT OF $500
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**This was not met as evidenced by staff 2 (S2) is fingerprint cleared and not associated to facility.

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Type A
09/26/2026
Section Cited
CCR87465(a)(4)

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(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (2) The licensee shall provide assistance in meeting necessary medical and(4) The licensee shall assist residents with self-administered medications as needed.
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Medication removed and secured from R2's bedroom at time of visit.

DEFICIENCY CLEARED DURING VISIT
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***This was not met as evidenced by LPA observed medications dispensed in cups in resident 2 (R2's) bedroom.
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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.
See Moua
NAME OF LICENSING PROGRAM MANAGER:
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/25/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/25/2026


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Document Has Been Signed on 09/25/2026 03:38 PM - It Cannot Be Edited


Created By: Melinda Medina On 09/25/2026 at 01:15 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: A COMFORT CARE HOME
FACILITY NUMBER: 157206689

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/26/2026
Section Cited
CCR
87309(a)

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(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage.
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Medication was in R2's room was secured, medication cabinet was locked and secured, and shed was locked and secured during visit.

DEFICIENCY CLEARED DURING VISIT.
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***This was not met as evidenced by LPA observation of dispensed medication in R2's bedroom, medication cabinet unlocked, medications in kitchen and in enclosed hallway passageway to garage accessible to residents. Shed in backyard unlocked containing pool chemicals and tools.
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Type A
09/26/2026
Section Cited
CCR87705(d)

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Care of Person with Dementia: (d) The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates accessible to those residents who may be at risk for elopement, as defined in Section 87101, Definitions.
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All auditory alarms were placed into the "on" position during inspection.

DEFICIENCY CLEARED DURING VISIT.
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***This was not met as evidenced by LPA observed facility to be equipped with auditory alarms on all exit doors;however, not in the "on" position
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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.
See Moua
NAME OF LICENSING PROGRAM MANAGER:
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/25/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/25/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/25/2026 03:38 PM - It Cannot Be Edited


Created By: Melinda Medina On 09/25/2026 at 01:37 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: A COMFORT CARE HOME
FACILITY NUMBER: 157206689

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/02/2026
Section Cited
CCR
87555(b)(8)

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General Food Service Requirements: (b) The following food service requirements shall apply:(8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained.
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Licensee discarded all expired canned food from pantry. Licensee will ensure that all food in refrigerator is properly stored and labeled.

POC to be submitted to Fresno Regional Office by due date.
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***This was not met as evidenced by LPA observation of expired food in pantry, fruit that appears old.
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Type B
09/25/2026
Section Cited
HSC1569.618(c)(3)

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(c) The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: 3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR.
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S2 completed online course for CPR/First Aid during annual inspection and presented proof of completion to LPA.

DEFICIENCY CLEARED DURING VISIT
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**This was not met as evidenced by: LPA observed during file review that S2 did not have CPR/First Aid training and was working alone at time of LPA arrival.
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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.
See Moua
NAME OF LICENSING PROGRAM MANAGER:
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/25/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/25/2026


LIC809 (FAS) - (06/04)
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