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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547208783
Report Date: 01/25/2023
Date Signed: 01/25/2023 11:56:09 AM

Document Has Been Signed on 01/25/2023 11:56 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:FRONTIER IN THE WESTFACILITY NUMBER:
547208783
ADMINISTRATOR:FLORES-LOPEZ,DANIELFACILITY TYPE:
737
ADDRESS:32083 MANOTA CTTELEPHONE:
(559) 735-9564
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 4CENSUS: 4DATE:
01/25/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:19 AM
MET WITH:Argelia Martinez, Administrator
Program Supervisor Ismael Talavera
Plad (Quality Assurance) Antoinette "Ann" Moore(Tellez)		TIME COMPLETED:
12:15 PM
NARRATIVE
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On 1/25/23 at 10:19 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a case management - deficiencies inspection. LPA explained reason for inspection and was granted entry by staff. LPA met with Administrator (ADM) Argelia Martinez, Program Supervisor (PS) Ismael Talavera, and Plad (Quality Assurance) Antoinette "Ann" Moore(Tellez).

During an inspection on 8/3/22 by CCLD Investigative Branch (IB), S1 was interviewed as a staff of the facility and had been working at the facility for one year.

LPA interviewed PS. PS admitted S1 has been working in the facility since hired. S1's date of hire is 6/29/2021. Today, LPA found that S2 has been working in the facility since 1/9/23, 40 hours per week. S1 and S2 both have criminal record clearance with CCLD, but the Licensee failed to complete a transfer of criminal record clearance for S1 and S2 to this facility.

A deficiency is being cited based on interviews conducted and record review in accordance with the California Code of Regulations, Title 22, see LIC809D. A civil penalty is being assessed in the amount of $100 per day, for a maximum of 5 days, for both S1 and S2, for a total of $1000. See LIC421BG for more details.

An exit interview was conducted and a Plan of Correction was reviewed and developed with the Program Supervisor. A copy of this report and appeal rights were discussed and left with Program Supervisor Ismael Talavera, whose signature on this form confirms receipt of these documents.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Malia Thao
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2023
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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Document Has Been Signed on 01/25/2023 11:56 AM - It Cannot Be Edited


Created By: Malia Thao On 01/25/2023 at 11:25 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: FRONTIER IN THE WEST
FACILITY NUMBER: 547208783

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
01/26/2023
Section Cited
CCR
80019(e)(2)

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80019 Criminal Record Clearance
(e) All individuals subject to a criminal record review...shall prior to working,...in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 80019(f) or
This requirement is not met as evidenced by:
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Licensee completed the transfer of criminal record clearance for both S1 and S2 to this facility during the inspection. Licensee will submit proof of a written statement of the facility's procedure for ensuring new staff have a completed transfer of criminal record clearance, to CCL by POC due date.
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PS admitted S1 has been working in the facility since hired. S1's date of hire is 6/29/2021. Today, LPA found that S2 has been working in the facility since 1/9/23, 40 hours per week. S1 and S2 both have criminal record clearance with CCLD, but the Licensee failed to complete a transfer of criminal record clearance for S1 and S2 to this facility, which poses an immediate health, safety, or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Melinda Hoffmann
LICENSING EVALUATOR NAME:Malia Thao
LICENSING EVALUATOR SIGNATURE:
DATE: 01/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/25/2023


LIC809 (FAS) - (06/04)
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