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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 167209525
Report Date: 01/14/2025
Date Signed: 01/14/2025 02:01:53 PM

Document Has Been Signed on 01/14/2025 02:01 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: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:
01/14/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:05 AM
MET WITH:Licensee, Taelor OConnorTIME VISIT/
INSPECTION COMPLETED:
02:08 PM
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On 1/14/25 Licensing Program Analyst (LPA) M. Garza arrived to complete a pre-licensing visit. LPA met with Licensee/Administrator, Taelor OConnor explained reason for visit and was permitted entry into the facility.

Facility is in the process of pre-licensing. The facility currently has 5 residents with private rooms residing in home. Pre-Licensing is being completed for new owner. Facility currently has 3 residents on hospice.

Tour of facility inside and out was completed. Common areas observed with adequately furnishings and lighting. LPA observed an extra supply of linens and personal hygiene/grooming products. Kitchen observed with dishes, plates and utensils. Cleaning supplies/chemicals observed in a locked hallway closet. Medications locked in kitchen cabinet. Fire extinguishers present and charged. Purchased on 03-28-24. Fire alarm and carbon monoxide detectors are present and operational at time of visit. Water temperature observed at 118.9 degrees F. Outside of the facility toured. Exits open free of obstruction. Facility has a functioning phone. Phone number is: (559) 925-0878. First aid kits observed with required items.

Component III completed during this pre-licensing visit. At this time the facility is ready to be licensed. LPA reached out to CAB regarding name of facility being incorrect. Name needs to reflect EASY LIVING SENIOR HOME.

Exit interview completed with Licensee, Taelor OConnor. A copy of this report was provided.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE: DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
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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