<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547208243
Report Date: 01/03/2023
Date Signed: 01/03/2023 04:08:04 PM

Document Has Been Signed on 01/03/2023 04:08 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:ENCLAVE AT THE FOOTHILLSFACILITY NUMBER:
547208243
ADMINISTRATOR:PEREZ, KRISTINAFACILITY TYPE:
735
ADDRESS:10650 ROAD 256TELEPHONE:
(559) 527-5091
CITY:TERRA BELLASTATE: CAZIP CODE:
93270
CAPACITY: 100CENSUS: 16DATE:
01/03/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:56 PM
MET WITH: Michelle Garcia, Residential Service Coordinator (RSC) and Anthony “Tony” Cruz, MaintenanceTIME COMPLETED:
04:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 01/03/23, Licensing Program Analyst (LPA) M. Yang conducted a Case Management visit for the purpose of the change of status/increase in capacity application received at Fresno CCL office. LPA introduced self, stated the purpose of the visit, and was allowed entry into the facility. LPA met with Michelle Garcia, Residential Service Coordinator (RSC) and Anthony “Tony” Cruz, Maintenance. LPA requested to meet with Administrator. Staff stated staff contacted Administrator Kristina Perez and Assistant Administrator Javier Hernandez and not available to attend meeting. LPA conducted tour with RSC and Maintenance.
LPA has received fire clearance for 100 ambulatory for a total capacity of 100 clients from local Fire Department. LPA toured the new buildings with RSC and Maintenance. LPA toured building 5 and building 6.
Building 5, Capacity: 40
The tour started at building 5.LPA observed building to be uncleaned. Facility was observed at a temperature 57-degree F. and no passageway obstructions or fire hazards were observed inside or outside.
LPA observed one dining room window panel missing and window screen in disrepair. Dining room window observed with no window blinds. A tour of the kitchen was conducted and observed to be equipped.Common areas were properly furnished and well-lit throughout. Fire Alarm Pull stations in multiple locations. Fire extinguisher was last serviced 08/04/22. A tour of all the rooms were conducted. Bedrooms were observed furnished and with adequate lightening. Bathrooms were toured. LPA observed toilet bowl in men bathroom not functioning. Bathrooms were observed uncleaned. LPA unable to test hot water temperature due to building gas turned off. Staff unable to access gas lock. Medications rooms were observed and will be kept in locked room. Laundry rooms, chemicals, and hazardous materials will be kept in locked rooms. Smoke detectors was observed. Carbon monoxide was not observed during inspection. LPA was unable to check smoke detectors because staff did not have access to operate smoke detector.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: ENCLAVE AT THE FOOTHILLS
FACILITY NUMBER: 547208243
VISIT DATE: 01/03/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Building 6, Capacity: 40
A tour of building 6 was conducted next. LPA observed building to be uncleaned. Facility was observed at a temperature 55-degree F. and no passageway obstructions or fire hazards were observed inside or outside. A tour of the kitchen was conducted and observed to be equipped. Common areas were properly furnished and well-lit throughout. Fire Alarm Pull stations in multiple locations. Fire extinguisher was last serviced 08/04/22. A tour of all the rooms were conducted. Bedrooms were observed furnished and with adequate lightening. All bathrooms were observed not functioning and uncleaned. Bathroom sink not functioning with no running water. LPA unable to test hot water temperature due to building gas turned off. Staff unable to access gas lock. Medications rooms were observed and will be kept in locked room. Laundry rooms, chemicals, and hazardous materials will be kept in locked rooms. Room 20 was observed with an exposed unfinished wall in ceiling. Smoke detectors was observed. Carbon monoxide was not observed during inspection. LPA was unable to check smoke detectors because staff did not have access to operate smoke detector.

Capacity increase is not approved at this time. The department will conduct a follow-up inspection once correction has been made. Correction has been discussed with RSC. A copy of this report was provided to RSC.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2