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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 160400627
Report Date: 07/27/2023
Date Signed: 07/27/2023 01:21:24 PM


Document Has Been Signed on 07/27/2023 01:21 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:VALLEY CHRISTIAN HOMEFACILITY NUMBER:
160400627
ADMINISTRATOR:ALVIDREZ, ERINFACILITY TYPE:
740
ADDRESS:511 E. MALONE ST.TELEPHONE:
(559) 585-3000
CITY:HANFORDSTATE: CAZIP CODE:
93230
CAPACITY:131CENSUS: 65DATE:
07/27/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Administrator, Erin AlvidrezTIME COMPLETED:
01:26 PM
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On 7/27/2023 Licensing Program Analyst (LPA) M. Garza arrived at facility to complete an unannounced case management visit. LPA met with Administrator, Erin Alvidrez, introduced self and was permitted entry into the facility. LPA completed a health and safety check on residents in care. LPA observed residents in common areas and in rooms.

During a previous complaint visit made on 3/6/2023, an interview was completed with Administrator. Upon touring facility, it was observed that one of the thermostats reviewed was observed to be at a higher temperature than the rest. (78 degrees F). The resident that resided in this room was overheard stating “it was hot” and "I can not open the window can I" to which Administrator responded "no". When asked why R1 was not able to change the thermostat to make their room more comfortable, the Administrator stated it was because it would change the temperatures in other rooms ran off that thermostat. When asked why R1 could not open their window, Administrator stated it was due to it changing the reading of the thermostat located in their room. This violates the personal rights of the residents in care.

Deficiency cited on 809D per Title 22. An exit interview was completed with Administrator, Erin Alvidrez. A copy of this report and appeal rights given.

SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -580-4596
LICENSING EVALUATOR NAME: Mary GarzaTELEPHONE: 559-365-9009
LICENSING EVALUATOR SIGNATURE:
DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/27/2023
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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Document Has Been Signed on 07/27/2023 01:21 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710


FACILITY NAME: VALLEY CHRISTIAN HOME
FACILITY NUMBER: 160400627

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/04/2023
Section Cited
CCR
87468.1(a)(2)

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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities ... (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.
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Administrator stated fans were offered, temperature changed on thermostat per R1 request as needed. Filters are being changed approximately every 2 months and more frequently as needed. In service training to be completed with all staff. Copy of in-service sign in sheet and training material to be provided to CCL by POC
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This requirement was not met as evidence by: LPA observation of 6 or 6 thermostats set to the same temperature. R1 was overheard by LPA of them informing staff it “was hot in their room” and they “open their window” and staff saying “no”. Staff failed to adjust their room temperature or open a window to make R1 more comfortable. This poses a potential health, safety and or personal rights risk to residents in care.
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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 MouaTELEPHONE: (559) -580-4596
LICENSING EVALUATOR NAME: Mary GarzaTELEPHONE: 559-365-9009
LICENSING EVALUATOR SIGNATURE:
DATE: 07/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/27/2023
LIC809 (FAS) - (06/04)
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