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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203358
Report Date: 08/15/2023
Date Signed: 08/16/2023 08:10:04 AM

Document Has Been Signed on 08/16/2023 08:10 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
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:
08/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:19 PM
MET WITH:Alicia Ortiz, Asst. AdministratorTIME COMPLETED:
02:30 PM
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On 08/15/23, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to conduct the required Annual Inspection Visit. LPA was greeted by Administrator Assistant, stated the purpose of the visit and was allowed entry into the facility.

LPA toured the facility inside and out and observed the facility temperature read at 75 degrees F. Resident bedrooms were observed to have the required lighting/furnishings and are free from odor and passageway obstruction/fire hazards. Facility bathrooms were observed to have operational lights, running water, and non- slip floors. Hot water temperature tested at 110 degrees F.

Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. A supply of extra linens were observed in the hall closet. Cleaning supplies were observed to be locked in a kitchen cabinet under the sink . LPA toured the kitchen observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored.

Covered trash cans with lids were observed throughout the facility. Hand washing postings were observed. Carbon monoxide and smoke detectors were observed to be operational. Outside of facility was toured and observed to be clean and free from obstruction. A self-closing and self-latching gate for emergency exit was observed. First aid kits were observed to contain all required items.

Medications were observed to be locked in a cabinet located in the office. Quarterly Emergency Disaster Drill logs were observed for staff.


(Continued on LIC 809-C)

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2023
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: POSITIVE DIRECTIONS #9
FACILITY NUMBER: 157203358
VISIT DATE: 08/15/2023
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(Continued from LIC 809)

The following documents are requested to be updated and submitted to Fresno CCL by: 08/28/23: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Proof of Liability Insurance, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents (LIC9020A)
An exit interview was conducted with Assistant Administrator.

Due to time restraints, a sample of Resident and Staff files will be reviewed at a later date on an annual continuation visit. A copy of this report was discussed and provided at the time of visit. No deficiencies cited on today's visit.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
LIC809 (FAS) - (06/04)
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