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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 207202556
Report Date: 10/13/2021
Date Signed: 10/13/2021 02:42:33 PM

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:MCALISTER'S RCFEFACILITY NUMBER:
207202556
ADMINISTRATOR:MC ALISTER, DUANEFACILITY TYPE:
740
ADDRESS:11976 RD 36 1/2TELEPHONE:
(559) 645-1861
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:6CENSUS: 4DATE:
10/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Duane Mcalister, AdministratorTIME COMPLETED:
10:30 AM
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On 10/13/2021, Licensing Program Analyst (LPA) M. Yang arrived unannounced at the above facility to conduct an Annual Inspection- Infection Control. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Maria Ibarra, caregiver. Upon entry staff was observed not wearing facial covering. LPA conduct tour with caregiver. Duane Mcalister, Administrator arrived in a short time later to conduct tour with LPA. Four residents were present during the tour. Visitor log-in/temperature check was observed upon entry.

Facility has one entrance/exit point. Facility appeared cleaned with no obstruction or fire clearance issues. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common and dining areas. LPA did not observe cough etiquette and social distancing signs. Food supply was checked and there appeared to be an adequate supply. Cleaning supplies were stored and locked in cabinet. LPA checked residents’ locked medications. All bathrooms are observed with trash cans with lid and securely fastened grab bars. Bathrooms have non-skid mat. LPA observed hand washing posting by bathroom sinks. LPA toured 4 single occupant resident room furnished and adequately lit. LPA did not observed a 30 day PPE supplies. Fire extinguisher observed to be last serviced 09/30/2021. Staff records were reviewed for good health and infection control training. All residents have updated emergency contact information.

No deficiencies issued during this inspection.

Exit interview was conducted. The following documents requested to be updated and submitted to Fresno CCL by 10/19/21: LIC 500, LIC 610, LIC 9020. Due to COVID-19 precautionary measures, a copy of this report will be provided via email and an electronic read receipt confirms receiving this email. Report signed on-site.

SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 243-8080
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021
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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