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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209365
Report Date: 01/29/2025
Date Signed: 01/30/2025 09:51:07 AM

Document Has Been Signed on 01/30/2025 09:51 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:BK HOUSE OF GRACE 2 LLCFACILITY NUMBER:
107209365
ADMINISTRATOR/
DIRECTOR:		BAJWA, JASWANTFACILITY TYPE:
740
ADDRESS:5742 EAST LORENA AVETELEPHONE:
(559) 515-6726
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 6CENSUS: 0DATE:
01/29/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Jaswant Bajwa, Administrator TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On January 29, 2025, Licensing Program Analyst (LPA) Rachel Bruce arrived for an unannounced annual inspection of this facility. No body was present at the home, LPA spoke with Administrator/ Licensee on the phone and she arrived shortly to the facility. There are currently no residents living in the facility, although Administrator/ Licensee is actively recruiting and hopes to have residents shortly.

A pre licensing inspection was successfully completed back in January of 2024. During this visit, LPA conducted the annual inspection utilizing the CARE tools, with Licensee, Jaswant (Rubie).

Common areas have adequate furnishings and lighting. All 4 client bedrooms have the required furnishings, bed linens, proper lighting and smoke detectors. LPA observed a supply of extra bed linens, towels, and personal hygiene and grooming products. Non-Skid mats are available, soap, paper towels present along with storage available for client personal items.

Kitchen observed to have supply of dishes, plates, utensils, pots and pans. Food storage and preparation areas are clear and appropriate for food preparation. Cleaning supplies and chemicals are locked in the lower kitchen cabinet and in locked cabinet in garage. Sharps/knives in a lock drawer in the kitchen. Appliances observed to be in working order. LPA observed there was not enough food per regulation but with no residents there will be no citation. Licensee understands regulatory requirements and will ensure compliance once residents are received. Garage is clean and free of obstruction. There is locked storage space available for chemicals and storage for additional food.

First aid kit, located where medications will be locked and stored, contains all the required items. Washer and Dryer observed in the laundry room with additional storage space available. Doors and passageways are unobstructed throughout the home.

Exit interview conducted with Administrator. A copy of this report will be provided via email
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Rachel A Bruce
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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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