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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209341
Report Date: 08/09/2023
Date Signed: 08/25/2023 01:10:15 PM

Document Has Been Signed on 08/25/2023 01:10 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:GOLDRIDGE HOME LLCFACILITY NUMBER:
107209341
ADMINISTRATOR:RIEMER, ROSEMARIE H.FACILITY TYPE:
740
ADDRESS:2145 GOLDRIDGE STTELEPHONE:
(559) 317-7442
CITY:SELMASTATE: CAZIP CODE:
93662
CAPACITY: 6CENSUS: 0DATE:
08/09/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:04 AM
MET WITH:Licensee, RoseMarie RiemerTIME COMPLETED:
12:08 PM
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On 08/09/2023 Licensing Program Analyst (LPA) M. Garza arrived at facility to complete a pre-licensing visit. LPA met with Licensee, RoseMarie Riemer, explained reason for visit and was permitted entry into the facility. LPA toured facility inside and out.

Tour of facility completed. Resident’s personal hygiene, grooming products, dishes and utensils were observed. Common areas have required furnishings and adequate lighting. All rooms will be shared. Bathrooms have non-slip mats, and hand washing signs present. Sharps/knives are inside a locked drawer in the kitchen. Medications will be locked in a cabinet located next to the kitchen. Cleaning supplies are stored in a locked cabinet in the garage and under locked sinks. Fire extinguisher is present and was serviced 3/25/23. Smoke detectors and carbon monoxide were present and operational at time of visit. Let-Us-Know posting observed to be correct sizing. .

Facility toured outside. Exits and walkways free of obstruction. Gate on side of facility was self-latching. Pool gate and lock present.



The following issues were observed: 6 of 6 resident beds observed without box springs, chairs and mattress pads. Bathrooms observed without grab bars and paper towels. 1 of 2 bathrooms observed with a trash can that has a tight fitting lid. Hot water temperature measured at 122 degrees F. Resident Rights,Visiting and investigation postings not present. Night lights not present.

Due to corrections needing to be made the Pre-Licensing was not complete and the Component III was not completed. No deficiencies cited during todays visit.

Exit interview completed with Licensee and a copy of this report was given.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2023
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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