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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209523
Report Date: 02/11/2025
Date Signed: 02/11/2025 02:58:17 PM

Document Has Been Signed on 02/11/2025 02:58 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:DIVINE MERCY CARE HOMES IIFACILITY NUMBER:
157209523
ADMINISTRATOR/
DIRECTOR:		ORILLOSA, NEILFACILITY TYPE:
740
ADDRESS:10200 LERWICK AVETELEPHONE:
(661) 412-4845
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 6CENSUS: 0DATE:
02/11/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Neil Orillosa, LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
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On 02/11/25, Licensing Program Analysts (LPA) M. Yang conducted an announced Pre-licensing /
Component III Inspection. LPA introduced self, stated the purpose of the visit and was allowed entry into
the facility. LPA met with Licensee 1(L1) Neil Orillosa.

LPA toured the facility with L1. The facility is a 3 bedroom, and 2 bathroom home and fire clearance were granted for 6 non-Ambulatory for a total capacity of 6. There are no residents present during this inspection. Facility was free from ground obstructions and odor free.

Common areas were observed to have adequate seating and lighting available. Medications and sharps will be locked and stored in kitchen shelf. First aid kit was observed and did not contain all required items. Kitchen was toured and observed to have dishes, plates, and utensils. Knives will be kept locked in kitchen drawer. Refrigerator temperature maintained at 35 degrees F and freezer maintained at 0 degree F. Adequate
non-perishable food observed. Perishable food supplies will be purchased prior to resident reside at facility.

LPA observed an extra supply of bed linens and towels. Bedrooms were toured. Bedroom observed with mattress, bedspread, top sheet, and bottom sheet with pillow. Bathroom observed operational and functional. Bathroom observed with non-skid mat. Hot water temperature tested at 115.3 degrees F in bathroom and 117.6 in master bathroom. A fire extinguisher was observed and had a service date of 09/16/24. Outside of facility toured. Exits were open and free of obstructions. LPA observed side gate to be self-latching and free debris. Smoke detectors and carbon monoxide were observed to be operational during this inspection.

Facility phone number 661-412-7100.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: DIVINE MERCY CARE HOMES II
FACILITY NUMBER: 157209523
VISIT DATE: 02/11/2025
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The following observed will need to be brought into compliance:
1. Night light in hallway
2. First aid kit did not have all required items
3. All bedrooms have no blankets
4. Bedroom furniture observed with no chair
5. All bathroom have no grabbed bar in the shower/ tub.

A follow up inspection will be scheduled once all above items are in compliance.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
LIC809 (FAS) - (06/04)
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