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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547206804
Report Date: 10/14/2022
Date Signed: 10/23/2022 09:51:35 AM

Document Has Been Signed on 10/23/2022 09:51 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:ORDUNO HOME 3FACILITY NUMBER:
547206804
ADMINISTRATOR:ORDUNO, LAURAFACILITY TYPE:
735
ADDRESS:515 N PLANO STTELEPHONE:
(559) 784-4980
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 6CENSUS: 4DATE:
10/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:54 PM
MET WITH:Carol Orduno
Laura Orduno		TIME COMPLETED:
03:25 PM
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On this date 10/14/22, Licensing Program Analyst (LPA) M. Medina conducted an Annual Required Inspection. LPA met with Licensees, Carol Orduno and Laura Orduno. A tour of the facility was conducted. COVID-19 guidelines are in place. Visitor log-in/temperature check was observed upon entry. Facility has one entrance/exit point, all staff and visitors enter through front door.

Facility appeared clean with no obstruction or fire clearance issues. Hand sanitizer was readily available to resident and visitors. Social distancing is maintained in the common and dining areas. Bathrooms have trash cans with lid. Resident bedrooms toured, all rooms are private. LPA checked residents’ medications and observed a 30-day supply. Food supply was checked and there appeared to be an adequate supply.

Licensee to submit Infection Control Plan to Department no later than 10/14/22.

No deficiencies were observed. Exit interview was conducted. Report signed during inspection and a copy left for facility file.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2022
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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