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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206726
Report Date: 04/17/2024
Date Signed: 04/17/2024 02:19:04 PM


Document Has Been Signed on 04/17/2024 02:19 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:HERITAGE LIVING IFACILITY NUMBER:
157206726
ADMINISTRATOR:TINA MALHIFACILITY TYPE:
740
ADDRESS:10411 BLYTHE CT.TELEPHONE:
(661) 664-9535
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:6CENSUS: 6DATE:
04/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Licensee/ Administrator Tina Malhi, House manager Lorena Malhi, and Administrator Sharnpreet MalhTIME COMPLETED:
02:30 PM
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On 04/17/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit.
introduce self, stated the purpose of the visit and requested to meet with the Administrator. LPA met caregiver Emilie Munoz. Licensee/ Administrator (L1) Tina Malhi was called and arrived shortly. House manager Lorena Malhi and Administrator Sharnpreet Malhi arrived shortly during visit. All six residents were 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. Extra linens were observed. An adequate supply of perishable and non-perishable food was observed. Sharps observed locked in kitchen drawers. Fire extinguisher was observed with a purchased date of: 06/07/23. Medications were observed locked in closet. MARs were reviewed. Cleaning supplies were observed locked in garage cabinet. All bedrooms were observed to have the required furnishings and with adequate lightening. The bathrooms were toured and observed operational during inspection. Non-skid mat and grabbed bars were observed. Hot water temperature was tested at 109.0 degree F in the bathroom 1, 115.3 degree F in bathroom 2, and range at 112.4 and 116.2 degrees F in master bathroom. Outside of facility toured and observed to be free of debris. Side gate observed self-closing and self-latching. Adequate outdoor seatings available for residents. Staff and residents' files were reviewed.

Due to time constraint, LPA will return at a later date to complete the inspection.

Exit Interview conducted. A copy of this report was provided to Licensee, whose signature on this form confirms receipt of this report.
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -65-7912
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:
DATE: 04/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/17/2024
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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