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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208969
Report Date: 08/22/2024
Date Signed: 08/22/2024 11:13:04 AM

Document Has Been Signed on 08/22/2024 11:13 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:PATTI ROSE HOMEFACILITY NUMBER:
157208969
ADMINISTRATOR/
DIRECTOR:
HARDGE, TAMERRA AFACILITY TYPE:
735
ADDRESS:3150 PATTI ROSE AVENUETELEPHONE:
(661) 266-4336
CITY:ROSAMONDSTATE: CAZIP CODE:
93560
CAPACITY: 4CENSUS: 0DATE:
08/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:Administrator Terrence HardgeTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 08/22/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced for Required Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Administrator Terrence Hardge. LPA was allowed entry into the facility. LPA toured the facility with Administrator. There are no client residing at the facility.

Facility was observed at a comfortable temperature, clean, and no passageway obstructions or fire hazards inside. Facility was free from ground obstructions and odor free. Common areas were observed to have adequate seating and lighting available. Kitchen was toured and observed. Refrigerator temperature was maintained at 40 degrees F and freezer temperature was maintained at -4 degrees F. A fire extinguisher was observed with a purchased date of 08/21/24.

Knives and cleaning supplies were observed kept locked and secure in the dining cabinet. Medications observed on top shelf locked in dining cabinet. First Aid Kit observed with all require items. LPA observed an extra supply of bed linens. LPA observed vacant bedrooms to have required furnishings. Bathrooms were observed to be operational. Hot water tested at 116.1 degrees F in bathroom 1 and range between 110.9 and 110.2 degrees F in vacant master bathroom.


Outside of facility toured. Outdoor seatings were observed available for clients. Exits were open and free of obstructions. LPA observed side gate to be self-closing and self-latching. Smoke detectors and carbon monoxide detectors were observed to be operational during this inspection.

No deficiencies issued during this inspection.

Exit interview was conducted. The following documents are requested and submitted to Fresno CCL by:


08/28/24. Forms requested: Lic 308, Lic 500, Lic 610D, and current Administrator Certificate. A copy of this report and appeal rights 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: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2024
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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