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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209175
Report Date: 08/22/2024
Date Signed: 08/22/2024 02:45:18 PM

Document Has Been Signed on 08/22/2024 02:45 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:HERITAGE LIVING IIIFACILITY NUMBER:
157209175
ADMINISTRATOR/
DIRECTOR:		GREWAL, SHARNPREETFACILITY TYPE:
735
ADDRESS:3900 DOS LAGOS DRIVETELEPHONE:
(661) 735-5211
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 6CENSUS: 6DATE:
08/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:Licensee Tina Malhi and Administrator Sharnpreet MalhiTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 08/22/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit.
introduce self, stated the purpose of the visit and met caregiver Harvinder Kaur. LPA toured facility with caregiver. Licensee Tina Malhi and Administrator Sharnpreet Malhi was called and arrived shortly. Four residents were 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 or outside. An adequate supply of perishable and non-perishable food was observed. The temperature is maintained for refrigerator at 40 degrees F and freezer at 0 degrees F. Fire extinguisher was observed with a service date of: 04/18/24. Fire drill last completed: 07/16/24. Medications observed locked under kitchen counter. MARs were reviewed medications were checked. Knives observed locked in kitchen drawer. Cleaning supplies and chemicals locked under kitchen sink, hall closet and in laundry room. All bedrooms were observed to have the required furnishings and with adequate lightening. Extra linens observed. The bathrooms were toured. Bathrooms were observed operational during inspection. Hot water temperature was tested at 118.7 degrees F in bathroom 1 and between 118.9 and 118.8 degree F in the bathroom 2. Washer was observed operational during visit. Outside of facility toured. Side gate observed self-closing. Adequate outdoor seatings available for clients. Carbon monoxide and smoke detectors were tested and observed to be operational. Sample of client’s and staff files were reviewed to have all the required documents.

No deficiency cited during inspection.

Exit Interview 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 was provided to Licensee, 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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