<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208962
Report Date: 06/15/2023
Date Signed: 06/15/2023 02:02:33 PM

Document Has Been Signed on 06/15/2023 02:02 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:ARCADIA GARDENS RESIDENTIAL CARE IVFACILITY NUMBER:
157208962
ADMINISTRATOR:ROURA, OLIVIAFACILITY TYPE:
740
ADDRESS:12301 RIVERFRONT PARK DRIVETELEPHONE:
(661) 699-3786
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 6CENSUS: 5DATE:
06/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Olivia Roura, LicenseeTIME COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 6/15/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct a Annual
visit. LPA introduced self, stated the purpose of the visit, and was greeted by Licensee (L1) Olivia Roura.
LPA was granted entry into the facility. LPA toured facility with L1 toured facility with staff. All five residents were present during inspection. LPA conducted interviews with staff.

The tour started in the kitchen into the common areas, to the client's bedrooms, and bathrooms. The facility was observed to be at a comfortable temperature of 73 degrees F, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. An adequate supply of perishable and non-perishable food was observed. Temperature observed refrigerator maintain a 40 degrees F and freezer temperature at 0-degree F. Fire extinguisher was observed with a service date of: 03/30/23. Cleaning supplies and chemicals stored and locked under kitchen sink.

LPA toured all resident’s bedrooms and observed 5 single occupant rooms. Residents’ room observed to be adequately furnished with bed, dresser, and adequate lighting. Bathrooms were properly equipped, and the hot water temperature was tested at 107.8 degrees F in bathroom 1 and range between 107.8- and 108-degrees F in shared master bathroom. Outside of facility toured. Side gate was self-closing and self-latching. Carbon monoxide and smoke detectors were tested and observed to be operational. Medications are kept locked in hall closet. MARs were reviewed. All residents’ file reviewed to have update emergency contacts, Admission agreement, and Pre-Appraisal. A sample of staff files were also reviewed. Staff files were observed to have current First Aid/CPR, Health screening, and Personnel record. Staff are fingerprinted clear and associated to the facility.

No deficiency cited during inspection. Exit Interview conducted. LPA received copies of Lic 500, Lic 610E, Lic 9020, and current Administrator certificate. The following documents are requested and submitted to Fresno CCL by: 6/21/23. The following updated forms were requested: Lic 308, Lic 309, Lic 808, Lic 9282 and current liability insurance. A copy of this report was provided to Licensee.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/15/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5