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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208910
Report Date: 02/04/2025
Date Signed: 02/04/2025 01:14:12 PM

Document Has Been Signed on 02/04/2025 01:14 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:VILLA HERMOSAFACILITY NUMBER:
157208910
ADMINISTRATOR/
DIRECTOR:		MANIGQUE, LESTERFACILITY TYPE:
735
ADDRESS:10808 VILLA HERMOSA DRTELEPHONE:
(661) 556-5293
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 4CENSUS: 4DATE:
02/04/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Brandy Frazier , Program DirectorTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
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On 02/04/25, Licensing Program Analyst (LPA) M. Yang unannounced to conducted case management visit to the facility. LPA introduce self, stated the purpose of the visit, and requested to meet with Administrator. Administrator Lester Manigque was called and stated unable to attend meeting. Administrator stated Authorized Program Director Brandy Frazier to attend meeting. Program Director was called and arrived shortly. LPA met with Program Director Brandy Frazier.

The purpose of the visit is to conduct a health and safety visit on the clients in care and address an incident that had occurred on 01/02/25 involving C1 and S1. On 01/02/25, C1 started to have behavior, yelling and insulting S1. S1 then said multiple times to C1 “go ahead hit me,” leading C1 to raise the client’s fist at S1. Facility conducted internal investigation that concluded S1 stated to C1, “go ahead hit me,” multiple times.

Therefore, as mentioned, S1 began to direct C1 to hit S1 by saying “go ahead hit me,” after C1 was yelling and insulting S1. As a result, a deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached Lic 809D. An exit interview was conducted. A copy of this report and appeal rights was provided to Administrator, whose signature confirms receipt of this report.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/04/2025
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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Document Has Been Signed on 02/04/2025 01:14 PM - It Cannot Be Edited


Created By: Mai Yang On 02/04/2025 at 11:35 AM
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: VILLA HERMOSA
FACILITY NUMBER: 157208910

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/05/2025
Section Cited
CCR
80072(a)(1)

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80072(a)(1) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: To be accorded dignity in his/her personal relationships with staff and other persons.

This requirement is not met as evidenced by:
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S1 was terminated on 01/16/25 and all staff was retrained in an in-service training on client’s behavior support plans.
Administrator shall submit written documentation of steps the facility will take to ensure regulations will be met which will include how de-escalation client during behaviors to Fresno CCL by POC due date 02/05/25.
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Based on interviews and records review, S1 began to direct C1 to hit S1 by saying “go ahead hit me,” after C1 was yelling and insulting S1, which poses an immediate health and safety risks to persons in care.
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All staff in-service training will be conducted. Training materials and staff attendance rooster will be submitted to the Fresno CCL by 02/21/25.

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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.
SUPERVISOR'S NAME:See Moua
LICENSING EVALUATOR NAME:Mai Yang
LICENSING EVALUATOR SIGNATURE:
DATE: 02/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/04/2025


LIC809 (FAS) - (06/04)
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