<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 207209367
Report Date: 08/23/2024
Date Signed: 08/23/2024 11:09:36 AM

Document Has Been Signed on 08/23/2024 11:09 AM - 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:OUR HOUSE - WESTGATEFACILITY NUMBER:
207209367
ADMINISTRATOR/
DIRECTOR:		LENNEMANN, DANAFACILITY TYPE:
740
ADDRESS:2816 WESTAGTE DRIVETELEPHONE:
(559) 661-8961
CITY:MADERASTATE: CAZIP CODE:
93637
CAPACITY: 6CENSUS: DATE:
08/23/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:04 AM
MET WITH:Administrator Dana LennemannTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 8/23/2024 Licensing Program Analysts (LPAs) B. Miranda & M. Vega arrived at the facility announced to conduct a Pre-Licensing visit. LPAs met with Administrator Dana Lennemann, Celeste Fisher, Noemi Gallo.
LPAs toured the facility inside and out including entry, kitchen, dining, living room, bedrooms, bathrooms, and exterior.
LPAs observed the facility to be at a comfortable temperature, clean, and odor free. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. Emergency phone numbers are listed. Trash cans have proper tight fitting covers, non-slip mats, and grab bars in the bathrooms.

Facility capacity is 6, with a current census of 6. Facility has 3 bedrooms and 2 bathrooms. Resident’s share bedrooms. Fire extinguishers have been services as of 5/31/2024 and are in good standing with charge. Smoke detectors and carbon monoxide detectors were tested and are in working condition. Water temperature was checked in common bathroom and read at 107.2 degree Fahrenheit. Fire inspection was previously cleared for 6 Non-Ambulatory.

LPAs observed no deficiencies at this time.

Component III was also conducted and completed. Exit interview was conducted. Pre-licensing requirements
were met. An exit interview was conducted with Administrator. Report signed on-site by Administrator and
printed copy was provided.

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1