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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547208243
Report Date: 06/12/2023
Date Signed: 06/12/2023 04:11:06 PM

Document Has Been Signed on 06/12/2023 04:11 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:HERNANDEZ, JAVIERFACILITY TYPE:
735
ADDRESS:10650 ROAD 256TELEPHONE:
(559) 527-5091
CITY:TERRA BELLASTATE: CAZIP CODE:
93270
CAPACITY: 100CENSUS: 17DATE:
06/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Javier Hernandez, AdministratorTIME COMPLETED:
04:19 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 6/12/23, Licensing Program Analyst (LPA) M. Medina and Licensing Program Manager (LPM) M. Hoffmann conducted an unannounced Annual Required Inspection. LPA introduced self and allowed entrance to facility. LPA and LPM met with Javier Hernandez and stated purpose of visit.

LPA Medina and LPM Hoffmann conducted facility tour with Administrator. At time of inspection it was observed that building #7 is the only building that is currently occupied with residents. Building #7 observed to be well lit, clean and odor free. All common areas observed to have adequate seating available. Resident bedroom all have private bathroom with showers. Water temperature measured in room 1, 5, 7 and observed to be within regulation. Kitchen toured, LPA observed menu posted for resident viewing. Facility has a 2-day supply of perishable food and a 7-day supply of non-perishable food available. Medication reviewed, LPA observed medication to be administered as ordered.
Building #5 and Building #6 toured, both buildings observed to be fully furnished and unoccupied at time of inspection. LPA Medina observed dining rooms, and TV areas in both buildings to have adequate seating available. Both buildings observed to have separate men's and women's restrooms with a common shower room with 5 shower heads.

Buildings #5, #6, #7 observed to have fire extinguishers present with a service day of 8/4/2022. Buildings #5, #6, #7 are equipped with pull stations and fire sprinklers.

Outside of facility toured. No exits observed to be obstructed.

No deficiencies cited. Exit interview conducted. A copy of signed report provided for facility records.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2023
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 1