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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209430
Report Date: 08/01/2024
Date Signed: 08/01/2024 03:00:20 PM

Document Has Been Signed on 08/01/2024 03:00 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:READY FOR CAREFACILITY NUMBER:
107209430
ADMINISTRATOR/
DIRECTOR:
BARKER, PAULINEFACILITY TYPE:
740
ADDRESS:4129 W PRINCETON AVETELEPHONE:
(599) 900-6377
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY: 6CENSUS: DATE:
08/01/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Pauline BarkerTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Katie Brown arrived at the facility to conduct a Pre-Licensing Inspection. LPA met with Administrator (AD) Pauline Barker.

LPA began the tour by entering through the front door of the 4 bedroom - 2 bathroom – one story home. All required postings were hung. Common areas were found to be well lit with ceiling fans throughout. Furniture was observed to be properly spaced and in good condition. Flooring is intact throughout the home. Smoke and Carbon Monoxide detectors were tested and found to be I working order. The Fire Extinguisher was observed and fully charged. LPA observed additional supply of paper products, bed linens, towels, personal hygiene/grooming products. Resident rooms are found to be in good repair and contained required linens, furnishings, and lighting. The resident bathrooms are clean, in good repair with grab bars and faucets delivering hot water at 112 degrees.

The kitchen was observed to have a supply of dishes, plates, utensils, and cooking items. Food storage areas are clear and appropriate for food preparation. Cleaning supplies, chemicals, and sharps/knives are all locked as required. Appliances were found to be in working order. LPA observed the required food supply. Resident medications will be stored in a designated locking cabinet. The First aid kits contained the required items. Doors and passageways are unobstructed throughout the inside of the home.

Outside of the facility was toured. There is a covered seating area and a self-releasing gate found to be working properly. LPA called and confirmed the facility phone number by calling (559) 800-9099.

See Lic809C for continuation of this report.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Katie Brown
LICENSING EVALUATOR SIGNATURE: DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/01/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: READY FOR CARE
FACILITY NUMBER: 107209430
VISIT DATE: 08/01/2024
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Emergency Disaster and Infection Control Plans were reviewed, and COMP III was conducted during this visit with AD. The applicant has met all pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.

An exit interview was conducted and a copy of this report was left with AD, whose signature confirms receipt of these documents.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Katie Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
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