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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547208809
Report Date: 03/21/2025
Date Signed: 03/21/2025 03:36:09 PM

Document Has Been Signed on 03/21/2025 03:36 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:PARK VISALIA ASSISTED LIVINGFACILITY NUMBER:
547208809
ADMINISTRATOR/
DIRECTOR:		AMANDA KELSEYFACILITY TYPE:
740
ADDRESS:3939 WEST WALNUT AVENUETELEPHONE:
(559) 625-3388
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY: 110TOTAL ENROLLED CHILDREN: 0CENSUS: 73DATE:
03/21/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:51 PM
MET WITH:Executive Director/ Administrator Amanda KelseyTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 3/21/2025, Licensing Program Analyst (LPA) K.Kaur conducted an unannounced Case Management visit. LPA introduced self and explained the reason for the visit to Executive Director/ Administrator Amanda Kelsey.

LPA arrived at the facility to conduct case management visit for death report for Resident (R1) dated 01/29/2025. LPA interviewed Memory Care Director Laureano Sanchez who stated death was unexpected. Ambulance and PD were contacted. Resident was admitted to the hospital on 01/26/2025 and discharged on 01/27/2025 with several Diagnosis and change to medication which was not implemented due to not receiving discharge papers in a timely manner. Primary doctor conducted a visit on 01/28/2025 and ordered medications however resident passed before they were received from pharmacy.

No deficiencies sited during this Case Management visit. An exit interview was conducted with Administrator. LPA will review the gathered documents and return at a later time if necessary. Report signed on-site and a copy of report was provided.
See MouaTELEPHONE: (559) -58-4596
Kamaldeep KaurTELEPHONE: 559-243-8080
DATE: 03/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2025
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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