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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547208819
Report Date: 11/17/2023
Date Signed: 11/17/2023 04:40:52 PM

Document Has Been Signed on 11/17/2023 04:40 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:PATRIOT IN THE WESTFACILITY NUMBER:
547208819
ADMINISTRATOR:DARLENE HATHCOCKFACILITY TYPE:
735
ADDRESS:3702 N SALLEE STREETTELEPHONE:
(559) 733-3631
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 4CENSUS: 3DATE:
11/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:17 PM
MET WITH:Darlene Hathcock, AdministratorTIME COMPLETED:
04:55 PM
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On 11/17/23 at 2:17 PM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection and was granted entry by Administrator (ADM) Darlene Hathcock.

LPA toured inside and outside of the facility. No obstructions observed. Smoke detectors and carbon monoxide detector tested and operational. Food supply sufficient. Sharps observed locked and inaccessible. Chemicals observed locked in hall closet. Bedrooms observed with sufficient furniture. Lighting observed sufficient throughout facility. Hot water measured 110.6 degrees F. Fire extinguishers last services 12/13/22. Sample of resident and staff files reviewed. Administrator certificate valid, certificate #: 6056824735.

No deficiencies cited during this inspection.

Exit interview conducted. A copy of this report was given to Administrator, whose signature confirms receipt of this report.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Malia Thao
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2023
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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