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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 167209525
Report Date: 01/02/2025
Date Signed: 01/02/2025 02:35:44 PM

Document Has Been Signed on 01/02/2025 02:35 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:EASY LIVING SENIOR CAREFACILITY NUMBER:
167209525
ADMINISTRATOR/
DIRECTOR:		OCONNOR, TAELOR J.FACILITY TYPE:
740
ADDRESS:419 CHAMPION ST.TELEPHONE:
(559) 925-1413
CITY:LEMOORESTATE: CAZIP CODE:
93245
CAPACITY: 6CENSUS: 5DATE:
01/02/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Licensee, Patrick & Taelor O'ConnorTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On 1/2/25 Licensing Program Analyst (LPA) M. Garza arrived to complete an announced visit with Licensees, Patrick & Taelor O'Connor. At the time of arrival LPA was informed that the facility was not ready to be pre-licensed.

This pre-licensing is a Change in Ownership. Currently there are 5 residents in care. 3 on currently receiving Hospice services.

Facility Pre-Licensing was rescheduled for January 14, 2025 @10 am.

No deficiencies cited during todays inspection.

Exit interview completed with Licensees, Patrick and Taelor. A copy of this report provided.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE: DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/02/2025
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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