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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206777
Report Date: 02/23/2024
Date Signed: 02/28/2024 01:49:34 PM

Document Has Been Signed on 02/28/2024 01:49 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:DESTINY HOUSEFACILITY NUMBER:
157206777
ADMINISTRATOR:HARDGE, TAMERRAFACILITY TYPE:
735
ADDRESS:2433 WILLIAMS COURTTELEPHONE:
(661) 279-5053
CITY:ROSAMONDSTATE: CAZIP CODE:
93560
CAPACITY: 4CENSUS: 4DATE:
02/23/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Administrator Terrence Hardge TIME COMPLETED:
01:45 PM
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On 02/23/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct subsequent visit for an Annual Inspection. LPA introduced self, stated the purpose of the visit, and requested to meet with Administrator. LPA met with staff Yolanda De Avila. Administrator Terrence Hardge was called and arrived shortly during tour. No client was 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 and outside. An adequate supply of perishable and non-perishable food was observed. Fire extinguisher was observed with a service date of: 09/29/23.



All clients’ rooms toured and observed to be adequately furnished and lit. Bathrooms were toured and observed operational during inspection. Hot water was tested to be maintained between 119.2 and 119.3 degrees F and master bathroom maintained between 118.8 and 118.4 degrees F. LPA observed medications locked in hall cabinet. MARs were reviewed. Cleaning chemicals were observed stored and locked in hall cabinet.

Outside was toured and observed free of debris. Outdoor seatings available for clients. All clients’ and staff files were reviewed to have all the required documents.

No deficiency observed during inspection.

Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 03/02/24. The following updated forms were requested: Lic 308, Lic 500, Lic 610D, Lic 9020, control of property, and current Administrator Certificate. A copy of this report was provided to Administrator.

SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2024
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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