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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208902
Report Date: 08/23/2023
Date Signed: 08/23/2023 11:20:04 AM

Document Has Been Signed on 08/23/2023 11:20 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:TRU FOUNDATIONFACILITY NUMBER:
157208902
ADMINISTRATOR:APPLE, TIFFANYFACILITY TYPE:
735
ADDRESS:11509 TAGUS DRTELEPHONE:
(661) 472-3577
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 6CENSUS: 2DATE:
08/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Tiffany Apple, Administrator TIME COMPLETED:
11:30 AM
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On 08/23/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit, and met with caregiver Jonathan Castillo. Administrator Tiffany Apple was called and arrived shortly. LPA toured facility with Administrator. All two clients were present during inspection.

The tour started in the kitchen into the common areas, to the client's bedrooms, and bathrooms. The facility was observed to be at a comfortable temperature of 76 degrees F, 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. Temperature maintained for refrigerator at 40 degrees F and freezer at 0 degrees F. Fire extinguisher was observed with a service date of: 04/11/23. Fire drill last completed:07/01/23. Cleaning supplies and chemicals stored and locked under stove drawer. Medications observed kept locked in kitchen shelf. MARs were reviewed. All bedrooms were observed to have required furnishings and with adequate lightening. Bathrooms were properly equipped and operational. Hot water temperature was tested at 110.7 in bathroom. Outside of facility toured and observed to be free of debris. Side gate observed self-closing. LPA observed available outside seatings for clients. Carbon monoxide and smoke detectors were tested and observed to be operational. All clients’ file reviewed to have update emergency contacts, Admission agreement, and Pre-Appraisal. Staff records were reviewed for good health. Staff files were observed to have current First Aid, fingerprinted clear and associated to the facility.

No deficiencies issued during this inspection. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 08/29/23. Forms requested: Lic 308, Lic 500, Lic 610D, Lic 9282, 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: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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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