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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209211
Report Date: 02/20/2025
Date Signed: 02/20/2025 03:39:29 PM

Document Has Been Signed on 02/20/2025 03:39 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:PATHWAY HOME CAREFACILITY NUMBER:
157209211
ADMINISTRATOR/
DIRECTOR:		DIAZ, DIANAFACILITY TYPE:
740
ADDRESS:410 LANSING DRIVETELEPHONE:
(661) 836-5705
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 6CENSUS: 4DATE:
02/20/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:10 PM
MET WITH:Elizabeth Ramos, ManagerTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 02/20/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct case management visit for the purpose of checking on the health and safety of the residents in care. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with caregiver Audie Green. Caregiver and LPA was unable to reach Administrator. Manager Elizabeth Ramos was called and arrived shortly and stated Administrator is unable to attend visit.

LPA tour facility. R1’s Admission agreement, Needs and Services Plan, Physician Report (Lic 602A), Care plan, Charting, Hospital Discharge record, medical appointment notes, Progress notes, and Incident Reports is requested to be submitted to the department by 02/21/25.

No deficiencies cited during today's inspection.

Exit interview conducted. A copy of this report was provided to Manager, whose signature on this form confirms receipt of these report.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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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