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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 275202698
Report Date: 04/23/2024
Date Signed: 04/23/2024 03:22:41 PM

Document Has Been Signed on 04/23/2024 03:22 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:BRIDGE HOUSEFACILITY NUMBER:
275202698
ADMINISTRATOR/
DIRECTOR:
MARISOL GUTIERREZ-ALVAREZFACILITY TYPE:
772
ADDRESS:601/603 BAYONET CIRCLETELEPHONE:
(831) 647-3000
CITY:MARINASTATE: CAZIP CODE:
93933
CAPACITY: 14CENSUS: 12DATE:
04/23/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:25 PM
MET WITH:Miriam Gonzalez Gomez & Jennifer HatchTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 4/23/24, Licensing Program Analyst (LPA) B. Miranda conducted a required unannounced Annual Inspection visit. LPA introduced herself, stated purpose of visit, and was allowed entrance by staff. LPA met with Miriam Gonzalez Gomez and Jennifer Hatch.


LPA toured the facility inside and out including entry, kitchen, dining, sample of bedrooms, bathrooms, and exterior. All fire exit routes were free and clear of obstructions. Medications are stored in a locked room in the facility. Toxins, cleaning supplies, knives and sharp objects are secured. Sample of resident's medication was observed by LPA with no deficiencies noted.

Facility has 8 bedrooms and 4.5 bathrooms. Fire extinguishers were last serviced as of 2/15/24. Smoke alarms and carbon monoxide detectors are combined and serviced annually. Copy of the service report will be provided to LPA by 4/30/24 or follow-up case management visit will be required. Water temperature was checked in a common bathroom upstairs and read at 109 degrees Fahrenheit.

Sample of resident & staff files were reviewed, and LPA observed files to be up to date and complete. Staff training is current including First Aid and CPR training.

LPA observed the facility to be clean, clutter free, and odor free. No citations issued per the California Code of Regulations Title 22.

Exit interview was conducted and a copy of this report LIC809 was provided to Miriam Gonzalez Gomez.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/23/2024
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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