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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547202421
Report Date: 12/12/2022
Date Signed: 12/12/2022 03:09:33 PM

Document Has Been Signed on 12/12/2022 03:09 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:BRYANT-LITTLE HOME 2FACILITY NUMBER:
547202421
ADMINISTRATOR:BRYANT, JANICEFACILITY TYPE:
735
ADDRESS:2733 WEST COUNTRY LANETELEPHONE:
(559) 802-3589
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY: 4CENSUS: DATE:
12/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:29 AM
MET WITH:Elissa Duhaylonsod, Assistant AdministratorTIME COMPLETED:
10:00 AM
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On 12/12/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection - Infection Control. LPA introduced self, stated the purpose of the visit, and requested to meet with Administrator. LPA met with designated representative (designee) Damon Bly. Elissa Duhaylonsod, Assistant Administrator and Janice Bryant was called and unable to attend meeting. LPA conducted tour with designee. There are currently four clients present during tour.

Upon entry facility staffs was observed with no facial covering. Visitor log-in/temperature check was observed upon entry. Hand sanitizer was readily available to clients and visitors. Facility has one entrance/exit point. Facility appeared cleaned with no obstruction or fire clearance issues. Social distancing is maintained in the common and dining areas. LPA observed social distancing and cough etiquette postings in facility.

LPA checked clients’ locked medications and observed a 30-day PPE supplies. Food supply was checked and appeared to be an adequate supply. LPA observed fire extinguisher served date: 10/03/22.

All clients’ room toured and observed to be adequately furnished and lit. LPA observed 4 bedrooms that are single occupant. All bathrooms observed trash bin with lid. LPA observed hand washing posting observed. Cleaning supplies were stored and locked in cabinet.The exterior tour was conducted. Outside free of debris. Staff records were reviewed for good health and infection control training. All clients’ records reviewed to have updated emergency contact information.

No deficiencies issued during this inspection.

Exit interview was conducted. Please submit the following forms/information to Fresno CCL by: 12/19/22. Requested forms/ information: Lic 308, Lic 400, Lic 402, Lic 500, Lic 610D, Lic 808, Lic 9282, and current Administrator Certificate. A copy of this report was provided to designated representative.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2022
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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