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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203358
Report Date: 06/29/2021
Date Signed: 06/29/2021 04:10:46 PM

Document Has Been Signed on 06/29/2021 04:10 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:POSITIVE DIRECTIONS #9FACILITY NUMBER:
157203358
ADMINISTRATOR:HOBBS, ANNFACILITY TYPE:
740
ADDRESS:329 EL CAMINO DRIVETELEPHONE:
(661) 721-3525
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY: 4CENSUS: 3DATE:
06/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:House Supervisor, Diane CervantesTIME COMPLETED:
02:44 PM
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On 06/29/2021, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. LPA met with House Supervisor, Diane Cervantes. Facility has one central entry and exit point. Visitor log-in/temperature check observed upon entry.

Facility appeared cleaned with no obstruction or fire clearance issues. Hand sanitizer was available to residents and visitors. Social distancing is maintained in the common and dining areas. Bathrooms have a trash can with a lid. Hand washing posters were observed by the bathroom sink. Bedrooms are single occupant.

LPAs checked residents’ locked medications. Food supply was checked and there appeared to be an adequate supply. Cleaning and PPE supplies were checked. Facility has a 30 day supply of required PPE. Staff records were reviewed for good health and infection control training. Facility staff was observed with mask on. Residents wear masks when away from the facility. Resident’s files have updated emergency contact information. Administrator certification is current.

No deficiencies were observed. Exit interview was conducted. Administrator was informed that as a COVID-19 precautionary measure, this report will be emailed and an electronic read receipt confirms receiving this document. Facility Representative signature on file.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2021
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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