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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209460
Report Date: 09/03/2024
Date Signed: 09/03/2024 12:23:17 PM

Document Has Been Signed on 09/03/2024 12:23 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
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:SATECAREFACILITY NUMBER:
107209460
ADMINISTRATOR/
DIRECTOR:
VICTOR FLAUTAFACILITY TYPE:
740
ADDRESS:75 N FAIRFAX AVETELEPHONE:
(209) 338-4730
CITY:CLOVISSTATE: CAZIP CODE:
93612
CAPACITY: 6CENSUS: 0DATE:
09/03/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Victor FlautaTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On September 3, 2024, Licensing Program Analyst (LPA) Daiquiri Boyd met with Licensee/Administrator Victor Flauta for the purpose of conducting a Prelicensing visit.

LPA toured facility. Common rooms have adequate furnishings and lighting. All five of the resident bedrooms have all the required furnishings and adequate lighting. Hot water temperature in bathrooms measured at 120 degrees F. LPA observed a supply of extra bed linens and personal hygiene and grooming products. Kitchen observed to have dishes, plates, utensils etc. Cleaning supplies are stored in locking cabinets in the garage, under the kitchen sink, under the bathrooms sinks, as well as above the laundry area. Medications are locked in a medication closet in the hallway. A fire extinguisher is present and has a purchase date of 04/01/2024. Smoke detectors and carbon monoxide were operating.

Outside of the facility toured. Exits open and free of obstruction. The residence has alarmed exit doors which sounds the indoor alarm. No outside hazards were observed. No pools or bodies of water.

All required postings are posted. Resident plans to update the size of the postings by the front door. Facility phone number will be (559)797-4637 and LPA called the number to ensure it is working.

Component III was conducted during pre-licensing visit with Applicant.

Applicant will make corrections as stated per LIC812 and will submit to LPA by September 10, 2024.

Once Licensee completes corrections, LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Daiquiri Boyd
LICENSING EVALUATOR SIGNATURE: DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/03/2024
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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