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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209329
Report Date: 08/17/2023
Date Signed: 08/17/2023 09:47:04 AM

Document Has Been Signed on 08/17/2023 09:47 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:PATHWAY HOME CAREFACILITY NUMBER:
157209329
ADMINISTRATOR:JOHNSON, JONATHANFACILITY TYPE:
735
ADDRESS:412 LANSING DRIVETELEPHONE:
(661) 972-4646
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 4CENSUS: 0DATE:
08/17/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Administrator Diana DiazTIME COMPLETED:
09:55 AM
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On 08/17/2023, Licensing Program Analyst (LPA) Yang arrived at the facility for an announced visit to conduct a follow-up the Pre licensing visit. LPA Yang met with Administrator Diana Diaz and discussed the purpose of the visit.

The following items were addressed since last inspection visit on 08/07/2023:
1. Bedroom 2 outlet was operating during inspection.
2. Freezer temperature was observed maintained at -4 degrees F.
3. Refrigerator temperature was observed maintained at 34 degrees F.
4. Facility thermostat was displayed at 74 degrees F and facility was at a comfortable temperature.
5. Non-perishable foods were observed available in the facility for clients. Perishable food will be purchased upon first client admission.
6. Fireplace was observed with a fireplace screened.

Component III was conducted during pre-licensing visit with Applicants.

I have found that applicant has met all pre licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2023
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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