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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208844
Report Date: 06/09/2025
Date Signed: 06/09/2025 03:27:41 PM

Document Has Been Signed on 06/09/2025 03:27 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:LEGENDS RESIDENTIAL CAREFACILITY NUMBER:
157208844
ADMINISTRATOR/
DIRECTOR:		PINONO, LIZAFACILITY TYPE:
740
ADDRESS:9402 KINGSMILL LANETELEPHONE:
(661) 829-6222
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
06/09/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Liza PinonoTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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On 6/09/25, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required inspection. LPA Medina was allowed entrance by Direct Care Staff. Licensee/Administrator Liza Pinono contacted by telephone and arrived a short time later to conduct visit.

Currently, six (6) residents in care. All residents were present at time of inspection. Facility tour began in resident bedrooms, all bedrooms observed to have required accommodations. LPA observed the closet in master bedroom (Room #4) to have a bed with linen as well as other mattresses being stored, there were no personal belongings of residents in closet. In Bedroom 3 (Room #3), resident 1 (R1) and Bedroom 2 (Room#2) resident 2 (R2) both observed to have half bed rails. Residents bathrooms observed to be clean, and fixtures observed operational. LPA observed base board in hallway bathroom to be in need of repair and/or replacement. Bath/tub are have skid resistant mats, shower chairs, and grab bars. Hot water tested in both bathrooms with a water temperature of 111 degrees F. Dining room and living room have adequate seating and lighting for all residents in care. Kitchen toured, LPA observed adequate food supply for the residents in care. Medications observed to be locked and secured. Medication observed to have original labels and to be administered as prescribed.

Smoke Alarms and carbon monoxide detectors observed to be operational at time of visit. Fire extinguisher has a service date of 12/9/24. All cleaning supplies observed to be locked in secured in laundry room, garage and under kitchen sink.

Staff and resident files reviewed. All facility staff who require caregiver background checks have received criminal record index clearance or exemptions.
Sergiy PidgirnyTELEPHONE: (559) 246-0610
Melinda MedinaTELEPHONE: (559) 410-5914
DATE: 06/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 6
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.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 06/09/2025 03:27 PM - It Cannot Be Edited


Created By: Melinda Medina On 06/09/2025 at 02:08 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: LEGENDS RESIDENTIAL CARE
FACILITY NUMBER: 157208844

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/09/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
87202(a)
Fire Clearance
(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, LPA observed designated fire exit gate from backyard to front yard to be locked making exit inaccessible, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 06/09/2025
Plan of Correction
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Licensee/Administrator immediately unlocked and removed lock from exit gate.

DEFICIENCY CLEARED AT TIME OF INSPECTION
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Sergiy Pidgirny
NAME OF LICENSING PROGRAM MANAGER:
TELEPHONE: (559) 246-0610
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
TELEPHONE: (559) 410-5914
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2025


LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 06/09/2025 03:27 PM - It Cannot Be Edited


Created By: Melinda Medina On 06/09/2025 at 02:08 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: LEGENDS RESIDENTIAL CARE
FACILITY NUMBER: 157208844

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/09/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87303(a)
Maintenance and Operation
(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, LPA observed the base board in hallway bathroom in need of repair or replacement and exit door from kitchen has a security door in place which was observed to be rusted and in need of painting or replacement which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/27/2025
Plan of Correction
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Licensee will make necessary repairs and submit pictures to Fresno CCL by plan of correction due date.
Type B
Section Cited
CCR
87308(c)
Resident and Support Services
(c) General storage space shall be maintained for equipment and supplies as necessary to ensure that space used to meet other requirements of these regulations is not also used for storage.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, LPA observed the closet in master bedroom (Room #4) to have a bed with linen as well as other mattresses being stored, there were no personal belongings of residents in closet, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/27/2025
Plan of Correction
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Closet in master bedroom (Room #4) will be cleared of all items and stored in another area or disposed of. Pictures will be submitted to Fresno CCL by plan of correction due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Sergiy Pidgirny
NAME OF LICENSING PROGRAM MANAGER:
TELEPHONE: (559) 246-0610
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
TELEPHONE: (559) 410-5914
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2025


LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 06/09/2025 03:27 PM - It Cannot Be Edited


Created By: Melinda Medina On 06/09/2025 at 02:08 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: LEGENDS RESIDENTIAL CARE
FACILITY NUMBER: 157208844

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/09/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87555(b)(26)
General Food Service Requirements
(b) The following food service requirements shall apply: (26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, LPA did not observe a 7-day supply of nonperishable food available which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/27/2025
Plan of Correction
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Licensee to purchase non-perishable food to meet regulation and submit receipt to Fresno CCL by plan of correction due date.
Type B
Section Cited
CCR
87608(a)(5)(A)
Postural Supports
(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above LPA observed half bed rails for R1 and R2 without physician order which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/27/2025
Plan of Correction
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Licensee will obtain physician orders for half bed rails for R1 and R2 and provide a copy to Fresno CCL by plan of correction due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Sergiy Pidgirny
NAME OF LICENSING PROGRAM MANAGER:
TELEPHONE: (559) 246-0610
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
TELEPHONE: (559) 410-5914
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2025


LIC809 (FAS) - (06/04)
Page: 5 of 6
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: LEGENDS RESIDENTIAL CARE
FACILITY NUMBER: 157208844
VISIT DATE: 06/09/2025
NARRATIVE
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Outside area toured. Exit door from kitchen has a security door in place which was observed to be rusted and in need of painting or replacement. LPA observed designated fire exit gate from backyard to front yard to be locked making fire exit inaccessible.

Licensee/Administrator to submit current copy of Liability insurance, LIC 500, LIC 610E, and LIC 9020 to Fresno Regional Office no later than Friday, June 27, 2025.

All deficiencies observed are being cited on the attached 809-D. Immediate Civil Penalty Assessed.

Exit interview conducted with Licensee/Administrator, Liza Pinono. A plan of correction was developed by Licensee and discussed with LPA. A copy of this report and appeal rights were provided to Licensee for facility records.
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2025
LIC809 (FAS) - (06/04)
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