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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547209163
Report Date: 08/21/2023
Date Signed: 08/22/2023 03:47:33 PM

Document Has Been Signed on 08/22/2023 03:47 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:FARMER RESIDENTIAL HOMEFACILITY NUMBER:
547209163
ADMINISTRATOR:FARMER, RHONDIFACILITY TYPE:
735
ADDRESS:1061 S ROYAL OAKTELEPHONE:
(559) 920-2975
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 4CENSUS: 4DATE:
08/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
04:01 PM
MET WITH:Rhondi FarmerTIME COMPLETED:
04:47 PM
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Today, Licensing Program Analyt L. Xiong arrived at the facility unannounced to conduct the . LPAs met with Licensee/Administrator Rhondi Farmer informing them the purpose of the visit.

Infection Control plan has been submitted to Licensing. Infection control procedures described in the plan and observed by LPAs include: Daily symptoms screenings (for staff, persons in care and visitors), visitation policy, quarantine/isolation procedures, surveillance testing, infection control plan and identification of Rhondi Farmer as the Infection Control Lead, emergency staffing, PPE use, infection control training and procedures, documentation, postings and communication.

LPAs toured the facility inside and out. Required postings of signs to include hand washing, coughing etiquette and physical distancing were observed in the facility. Staff were all observed wearing face coverings. Facility has designated visitation areas. LPAs observed a 30 day supply of PPE and resident medications. Sinks are well stocked and liquid soap for hand washing and paper towels for hand drying were observed.

No deficiencies cited on today’s inspection.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2023
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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