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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 247203533
Report Date: 03/28/2023
Date Signed: 04/04/2023 10:23:25 AM

Document Has Been Signed on 04/04/2023 10:23 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:LOYD'S LIBERTY HOMES, INC.FACILITY NUMBER:
247203533
ADMINISTRATOR:MARIA E. PEREZFACILITY TYPE:
775
ADDRESS:1503 WEST MAIN STREETTELEPHONE:
(209) 725-7997
CITY:MERCEDSTATE: CAZIP CODE:
95340
CAPACITY: 75CENSUS: 48DATE:
03/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:07 AM
MET WITH:Administrator- Maria PerezTIME COMPLETED:
01:00 PM
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On 3/28/23 at 11:00 a.m. Licensing Program Analyst (LPA) B. Miranda arrived to the facility to conducted an unannounced Annual Required Inspection. LPA toured the facility with Administrator- Maria Perez. LPA explained the reason for the visit and a tour was conducted.

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 to be in good standing and last serviced 8/26/22. Hand washing and other various Covid-19 related signs were observed in the common areas

LPA toured the inside of the facility. LPA observed all exits to be clear and free from obstruction. Facility was at a comfortable temperature, odor free, and no passageway obstructions were observed. Clients were observed to be engaged in various activities and positive staff/client interaction was observed. Activity rooms were observed to be well equipped and furnished.

Water temperature was checked in one of the bathrooms and read at 111.2 F, bathrooms were observed to be properly equipped. AD stated smoke detectors are checked on a monthly basis by maintenance. LPA observed cleaning supplies and medication to be locked and inaccessible to clients. Sample medication and logs were reviewed. Medication was properly labeled and administered as ordered upon sample review. Sample staff and client files were reviewed.

Exit Interview conducted. The following documents are requested and need to be submitted to Fresno CCL by 4/7/23. LIC308, LIC309, LIC500, LIC610D, and LIC9020.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2023
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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