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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209216
Report Date: 08/21/2024
Date Signed: 08/21/2024 01:01:03 PM

Document Has Been Signed on 08/21/2024 01:01 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 HOMESFACILITY NUMBER:
157209216
ADMINISTRATOR/
DIRECTOR:
JOHNSON, JAIMYFACILITY TYPE:
740
ADDRESS:336 MONTCLAIR STTELEPHONE:
(661) 972-6051
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 4CENSUS: 4DATE:
08/21/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH: Administrator Jason Johnson and House manager Diana DiazTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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On 08/21/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct required Annual
inspection. LPA introduce self, stated the purpose of the visit, and met with Administrator Jason Johnson and House manager Diana Diaz. LPA toured facility with Administrator and House Manager. All four residents were present during inspection.

The facility was observed to be at a comfortable temperature, 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. Fire extinguisher was observed with a service date of: 07/10/24. Last fire
drill completed on 08/14/24. Chemicals were observed stored and locked under kitchen sink. Temperature maintained for refrigerator at 36 degrees F and freezer at -10 degrees F. All bedrooms were toured and observed to be required furniture and adequate lighting. Medications observed locked in hall closet. Washer and dryer functioning and operating during inspection Bedroom was observed furnished and good lighting. Bathrooms were toured. Toilet observed functional and operational. Non-skid strips and grabbed bars was observed. Hot water temperature was tested 109.9 degrees F in bathroom hall bathroom and 106.3 degrees F in shared bathroom. Outside of facility toured and observed to be free of debris. Adequate outside seatings observed available for resident. Carbon monoxide and smoke detector observed operational during inspection.

No deficiency cited during visit. Exit Interview conducted. A copy of this report was provided to Administrator via email, whose signature on this form confirms receipt of this report.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/21/2024
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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