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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209444
Report Date: 06/18/2024
Date Signed: 07/05/2024 11:45:34 AM

Document Has Been Signed on 07/05/2024 11:45 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:HELPING HANDS SENIOR CAREFACILITY NUMBER:
107209444
ADMINISTRATOR/
DIRECTOR:		NGUYEN, ELSAFACILITY TYPE:
740
ADDRESS:825 S WILLOW AVENUETELEPHONE:
(650) 776-2280
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 30CENSUS: 0DATE:
06/18/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Elsa Nyguen and Ray Gilbert, ApplicantsTIME VISIT/
INSPECTION COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Lissett Padgett arrived announced to conduct a Pre-Licensing inspection. LPA met with applicants Elsa Nguyen and Ray Gilbert.

This facility has 7 buildings on the premises and are as follows:
Building 1 address 877 S Willow, 3 bedroom, capacity for 6
Building 2 address 853 S Willow, 2 bedroom, capacity for 4
Building 3 address 825 S Willow, 2 bedroom, capacity for 4
Building 4 address 865 S Willow, 2 bedroom, capacity for 4
Building 5 address 841 S Willow, 3 bedroom, capacity for 6
Building 6 address 835 S Willow, 3 bedroom, capacity for 6
Building 7 address 881 S Willow, staff office

LPA began the tour by entering building 3. This building has been fully furnished. Ambient temperature was 74 degrees F. Common areas have adequate furnishings and lighting. All 3 resident bedrooms have the required furnishings, bed linens, proper lighting and smoke detectors. Smoke/Carbon Monoxide detectors were tested and observed and in working order. Windows and screens are in good condition. LPA observed a supply of extra bed linens, towels, and personal hygiene and grooming products. Hot water temperature in bathroom measured at 125.2 degrees F. LPA observed Non-Skid flooring in the showers, grab bars in shower and near toilet, 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. Knives and cleaning supplies and chemicals are stored in locked cabinet under the sink. Appliances observed to be in working order. LPA observed a 7 day of non-perishable food stored in a pantry and 2 day supply of perishable food in the refrigerator.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Lissett Padgett
LICENSING EVALUATOR SIGNATURE: DATE: 06/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2024
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
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: HELPING HANDS SENIOR CARE
FACILITY NUMBER: 107209444
VISIT DATE: 06/18/2024
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Washer and Dryer observed in the laundry closet with additional storage space available above. Doors and
passageways are unobstructed throughout the home.

First aid kit contains all the required items. A fire extinguisher is mounted on the wall, it did not have an inspection date but the correct pressure gauge as indicated on the meter.

Buildings 1-5 and Building 6 are will be furnished upon admission of residents.

Medications will be stored in locked medication cabinet in each building.

Outside of the facility toured. There is a seating area and a self-latching gate found to be working properly. LPA observed temporary fencing along the perimeter of the property. There is no swimming pool on the premises.

The following observed will need to be brought into compliance:
1. Trash can with lid in all bathrooms and in kitchens
2. Designated centrally stored medication cabinet installed in each resident building.
3. Install a lock on shed located at building 4 which stores paint supplies and chemicals.
3. Signal system to be installed in each resident building.
4. Install lock on cabinet that will store chemicals and knives/sharps
5. Lower water temperature within the 105-120 degree F range
6. Clean shower and floors in building 5
7. Install grab bar near toilet in building 5
8. Install screen in bedroom window in building 5
9. Emergency lighting (e.g. flashlights) to be placed in each building
10. Required postings in each building
11. remove fencing materials from the perimeter of grounds
12. Thermometers for refrigerator and freezer

A copy of this report was given to Applicants, whose signature confirms receipt of this report.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Lissett Padgett
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024
LIC809 (FAS) - (06/04)
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