Community Care Licensing

Document Has Been Signed on 01/17/2025 01:21 PM - It Cannot Be Edited

FACILITY NAME:	BONAVENTE HOME FOR THE ELDERLY #2		FACILITY NUMBER:	107207113
ADMINISTRATOR/ DIRECTOR:	BONAVENTE, NIDA		FACILITY TYPE:	740
ADDRESS:	6097 HARRISON		TELEPHONE:	(559) 313-9052
CITY:	FRESNO	STATE: CA	ZIP CODE:	93711
CAPACITY: 6		CENSUS: 6	DATE:	01/17/2025
TYPE OF VISIT:	Case Management - Deficiencies	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:39 AM
MET WITH:	Designee, Leticia Aldana		TIME VISIT/ INSPECTION COMPLETED:	01:25 PM

SUPERVISORS NAME: See Moua LICENSING EVALUATOR NAME: Mary Garza LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2025

Link to Parent Document Below:

FACILITY NAME: BONAVENTE HOME FOR THE ELDERLY #2	FACILITY NUMBER: 107207113
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/17/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/27/2025 Section Cited CCR 87219(a)(1)	1 2 3 4 5 6 7	(a) Residents shall be encouraged to maintain and develop their fullest potential for independent living through participation in planned activities. The activities made available shall include: (1) Socialization, achieved through activities such as group discussion and conversation, recreation, arts, crafts, music, and care of pets.	1 2 3 4 5 6 7	Administrator stated they will generate a schedule for activites to include the resdents in. A copy will be submitted to CCL by POC date.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: Based on LPA interviews, the licensee did not comply with the section cited above in that facility does not have activities for the residents. This poses a potential health, safety or personal rights risk to persons in care.	8 9 10 11 12 13 14
Type B 01/27/2025 Section Cited CCR87303(a)	1 2 3 4 5 6 7	(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.	1 2 3 4 5 6 7	Administrator stated discussions with Licensee and Designee will be completed and a POC will be submitted to CCL in writing by POC date. As corrections are being completed a log will be kept of the corrections completed and pictures will be sent as proof of correction.
	8 9 10 11 12 13 14	This requirement was not met as evidence by: Dishwasher non-functioning. Pool non-functioning & has dirty water. Mattress in R1's bedroom in need of replacement. R1's bedroom in need of touch up paint (near bed & near closet). Bedroom #2 restroom has broken tiles. Laundry room observed with holes in wall. Vent in laundry room in need of cleaning. Bedroom #3 door in need of repair. Bathroom #2 observed with bathtub and sinks in need of resurfacing. Bathroom #2 cabinets in need of repair or replacement. Bathroom #2 toilet missing toilet cover. Bathroom #3 in need of paint around toilet. Backyard patio roof observed with holes in need of repair. Garage observed with debris in need of removal. Large left side gate broken and in need of repair. Wires exposed on HVAC unit in need of repair. Right side gate does not latch properly and observed with broken board in need of repair. Driveway observed with missing concrete in need of repair. Kitchen observed with spider webs/dust above stove. Kitchen tiles broken and in need of replacement near sink and on counter. These poses a potential health, safety and or personal rights risk to residents in care.	8 9 10 11 12 13 14

SUPERVISOR'S NAME: See Moua LICENSING EVALUATOR NAME: Mary Garza LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2025