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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 247209076
Report Date: 02/11/2025
Date Signed: 02/12/2025 01:57:50 PM

Document Has Been Signed on 02/12/2025 01:57 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:G.L.O.M.A.R.F. 10FACILITY NUMBER:
247209076
ADMINISTRATOR/
DIRECTOR:
LIZETTE ZAMORAFACILITY TYPE:
735
ADDRESS:1259 LURS CTTELEPHONE:
(925) 570-3282
CITY:MERCEDSTATE: CAZIP CODE:
95348
CAPACITY: 6CENSUS: 6DATE:
02/11/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Administrator Lizetter ZamoraTIME VISIT/
INSPECTION COMPLETED:
12:46 PM
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On 02/11/2025, Licensing Program Analyst (LPA) V. Gorban arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility. LPA toured the facility with administrator Lizette Zamora, certification number 6059675735 and expiration date 07/05/2025.

The facility was observed to be at a comfortable temperature, of 72 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. During the visit the facility clients were out at day program. Department phone number and infection prevention information signs were posted thought the facility.

Inspecting kitchen LPA observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. An emergency disaster supply was observed.

A fire extinguisher was observed with service date of 06/21/2024. Last fire drill conducted on 02/01/2025 Private clients’ room observed to be at comfortable temperatures. The bathroom’s water temperature was tested and recorded reading of 105 degrees F.

Medications records storage observed to be locked in a cabinet. Cleaning supplies were observed to be in a locked cabinet in the storage it the laundry room. An outdoor seating area was observed operational for clients in care.

LPA reviewed staff and clients’ files. No deficiencies were observed and cited during this visit.

Exit interview conducted. A report was signed, and a copy of this report was provided for facility records.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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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