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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 160403663
Report Date: 05/17/2022
Date Signed: 05/17/2022 12:30:45 PM

Document Has Been Signed on 05/17/2022 12:30 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:KINGS REHABILITATION CENTER, INC.FACILITY NUMBER:
160403663
ADMINISTRATOR:ACOSTA, SUSANFACILITY TYPE:
775
ADDRESS:490 E. HANFORD ARMONA ROADTELEPHONE:
(559) 582-9234
CITY:HANFORDSTATE: CAZIP CODE:
93230
CAPACITY: 100CENSUS: 16DATE:
05/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Stephanie Sanchez-Program ManagerTIME COMPLETED:
02:15 PM
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On 05/17/2022, Licensing Program Analyst (LPA) K.Kaur arrived unannounced to conduct an Annual Inspection - Infection Control. LPA introduced self, stated the purpose of the visit, and met with Stephanie Sanchez-Program Manager. 9 clients were present during the inspection.

Visitor log-in/temperature check was observed upon entry. Staff observed with facial coverings. Hand sanitizer was readily available to clients and visitors. Fire extinguishers were observed with a service date of: 04/19/22. Hand washing and other various Covid-19 related signs were observed in the common areas.

LPA toured the facility inside and outside. All passageways and exits were clear and free from obstruction. Facility was at a comfortable temperature and well lit. All classrooms and activity areas were clean and odor free. Bathrooms were clean and fixtures were functioning properly. LPA observed multiple first-aid kits throughout the facility.

Facility dining area toured and appeared clean and is being used a open classroom to follow social distancing guidelines. Clients bring their own lunches to program. Lunches stored in refrigerator in facility kitchen.

No deficiencies were observed.

Exit Interview conducted. The following documents are requested and need to be submitted to Fresno CCL by:5/24/22. LIC308, LIC309, LIC500, LIC610D, and LIC9020.

An exit interview was conducted. Report signed on-site by Manager and a printed copy was provided.
SUPERVISORS NAME: Brenda White
LICENSING EVALUATOR NAME: Kamaldeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2022
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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