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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209500
Report Date: 01/10/2025
Date Signed: 01/22/2025 03:47:27 PM

Document Has Been Signed on 01/22/2025 03:47 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:OHANA CARE HOME CENTRAL VALLEY LLCFACILITY NUMBER:
107209500
ADMINISTRATOR/
DIRECTOR:		BARUELA, DARWIN BFACILITY TYPE:
740
ADDRESS:6952 E. ANDREWS AVETELEPHONE:
(559) 862-9471
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 6CENSUS: 2DATE:
01/10/2025
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Darwin Baruela, AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On 01/10/2025 Licensing Program Analyst (LPA) M. Garza arrived unannounced for a Post Licensing Inspection. LPA met with Licensee, Darwin Baruela. LPA explained reason for visit and was permitted entry into the facility. LPA completed a health and safety check on residents in care. Currently 2 residents reside at the facility. 1 of 2 residents was relaxing in the common living area. The second resident returned from the hospital during the visit. LPA observed healthy interaction between staff and residents.

LPA toured the facility inside and out with licensee. The following was noted.
  • LPA entered through the front door and observed the required postings in the entry/dining area.
  • LPA observed the residence to be a single story, 4 bedroom/ 2 bathroom home. There is a dining room and living room observed to have adequate furnishings and lighting. All bedrooms were observed to have beds, personal lighting and chest drawers to accommodate a total of 6 residents - 4 in shared rooms and 2 single rooms.
  • LPA observed fire extinguisher to be new and charged with a service date of May 13, 2024. Smoke detectors were tested and observed to be operational. Carbon Monoxide detector was observed to be functional and is located in the hallway. Emergency lighting /flashlights and night lights in the hallways by the bathrooms were observed.
  • LPA observed a adequate supply of towels. A supply of paper towels were observed in the bathrooms. Hot water temperature in bathrooms was unable to be tested due to broken thermometer. Non-Skid mats were present in the showers and grab bars were observed.
  • Kitchen observed to have adequate supply of dishes, plates, pots and pans. Food storage and preparation areas are clean and appropriate for food preparation. Appliances observed to be in working order. LPA observed a 7 day supply of non-perishable food and 2 days of perishable.
  • Cleaning supplies and chemicals are locked in the garage. A locked cabinet in the dining room is designated to store medications. Refrigerated medications are stored in a separate locked small refrigerator in the kitchen. Sharps/knives were observed in the locked pantry in the kitchen.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Rachel A Bruce
LICENSING EVALUATOR SIGNATURE: DATE: 01/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/06/2025
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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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: OHANA CARE HOME CENTRAL VALLEY LLC
FACILITY NUMBER: 107209500
VISIT DATE: 01/10/2025
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  • First aid kit was observed and inspected.
  • Washer and Dryer observed in the laundry room with additional storage space available in upper cabinets. Laundry soap and chemicals are stored and locked in laundryroom.
  • Doors and passageways are clear and free from obstruction throughout the home.
  • LPA toured the outside of the residence and observed a covered patio with adequate outdoor seating for activities. A self-latching gate found to be working properly.
LPA found no issues or areas of concern. Facility is in excellent condition and no citations will be issued at today's visit.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Rachel A Bruce
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
LIC809 (FAS) - (06/04)
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