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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209549
Report Date: 01/02/2025
Date Signed: 01/02/2025 11:26:34 AM

Document Has Been Signed on 01/02/2025 11:26 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:HERITAGE LIVING IVFACILITY NUMBER:
157209549
ADMINISTRATOR/
DIRECTOR:
GREWAL, SHARNPREETFACILITY TYPE:
735
ADDRESS:11005 TIPPERARY DRIVETELEPHONE:
(661) 979-0417
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 6CENSUS: 0DATE:
01/02/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Licensee Tina Malhi and Administrator Sharnpreet "Pree" MalhiTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 01/02/25, Licensing Program Analyst (LPA) Yang arrived to the facility announced to conduct the Pre
licensing visit. LPA Yang met with Licensee (L1) Tina Malhi and Administrator (A1) Sharnpreet "Pree" Malhi who granted LPA entry into the facility.

The facility is a 4 bedroom, and 3 bathroom home and fire clearance were granted for 6 non-ambulatory for


a total capacity of 6. There are no client present during this inspection. LPA toured the facility with L1 and A1.

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 to have dishes, plates, and utensils. A fire extinguisher was observed and had a service date of 09/29/24. First aid kit was observed with all required items. Refrigerator temperature maintained at 37 degrees F and freezer temperature maintained at 0 degrees F. LPA observed 2 day perishable and 7 day nonperishable food. Medications will be kept locked under kitchen counter. Cleaning supplies and chemicals observed locked under kitchen sink and in a laundry shelf. LPA observed an extra supply of bed linens and personal hygiene products. Bedrooms were observed to have the required furnishing and are ready for occupancy. Hot water temperature tested at 114.1 degrees F in bathroom 1, range 115.4 degree F and ranged at 118 and 117.7 degree F in master bathroom. Outside of facility toured. Exit were open and free of obstructions. Carbon monoxide and smoke detector was observed operational during inspection.

Facility phone number is (661)282-8965.

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: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/02/2025
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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