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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209368
Report Date: 04/11/2024
Date Signed: 04/12/2024 03:50:05 PM

Document Has Been Signed on 04/12/2024 03:50 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:A PLACE CALLED HOME: THE CHATEAUFACILITY NUMBER:
107209368
ADMINISTRATOR/
DIRECTOR:
MURCHISON, DAVID BRUCEFACILITY TYPE:
740
ADDRESS:3019 POWERS AVENUETELEPHONE:
(559) 213-7251
CITY:CLOVISSTATE: CAZIP CODE:
93619
CAPACITY: 10CENSUS: 0DATE:
04/11/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:37 AM
MET WITH:Administrator David MurchisonTIME VISIT/
INSPECTION COMPLETED:
11:05 AM
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On 04/11/2024 at 08:30 AM, Licensing Program Analyst (LPA) V Gorban conducted announced Pre-licensing visit. LPA identified himself and discussed the purpose of the visit. LPA conducted the inspection with the facility Administrator (AD) David Murchison.

An inside and outside tour of the facility was conducted with AD. Resident’s each room have adequate furnishings and lighting and all the required furnishings. Mattress, furniture, and linen appeared to be in good condition. Home is fire cleared for 10 (ten) bed ridden residents. LPA observed a supply of extra bed linens. Bathrooms were properly equipped, and trash cans had a fitting lid.


Hot water temperature was observed to be 114 degrees F. Kitchen observed to have dishes, plates, utensils. Sharps/knives and medications are locked in the kitchen. Cleaning supplies are stored. First aid kit contains all the required items. Fire extinguisher is present and was serviced on 03/14/2024. Smoke detectors and carbon monoxide are combined in one unit and were operating properly.

Outside of the facility toured. Exits open free of obstruction. Gate is self-latching. No outside hazards were observed. All required postings are posted. Facility phone number will be 559-797-4216.

Component III conducted during pre-licensing inspection.


LPA have found that applicant has met all pre licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.

Pre-Licensing is complete, and this facility has no deficiencies.

Exit interview conducted, report is signed and copy of the report provided to the Administrator.

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2024
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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