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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 247209284
Report Date: 03/22/2023
Date Signed: 03/22/2023 01:29:35 PM

Document Has Been Signed on 03/22/2023 01:29 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:ONE ACCORD RCFEFACILITY NUMBER:
247209284
ADMINISTRATOR:WANJAU, JOHNSON KAMUNYAFACILITY TYPE:
740
ADDRESS:1079 OHKI STTELEPHONE:
(951) 941-5192
CITY:LIVINGSTONSTATE: CAZIP CODE:
95334
CAPACITY: 6CENSUS: 0DATE:
03/22/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Administrator- Johnson K. WanjauTIME COMPLETED:
12:00 PM
NARRATIVE
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On 3/22/2023 at 10:30 am Licensing Program Analysts (LPAs) V Gorban and B Miranda arrived at facility to complete an announced Pre-Licensing visit. LPAs met with Administrator (AD) Johnson Wanjau.
LPAs toured the facility inside and out.

Physical plant toured. Regulations reviewed. Facility is clean & in good repair. Interior & exterior passageways free of obstructions. Items that could pose a danger, such as disinfectants, cleaning solutions, etc., are inaccessible. Sufficient lighting & furnishings in common area. Facility has a common area for residents interact with each other. Locked centralized storage area for medications. First aid kit complete. Hot water tested & measured in kitchen and read at 118 degrees F. Physical plant is consistent with the facility sketch/floor plan. Fire extinguisher purchased with receipt attached, current and in good standing. Smoke & carbon monoxide detectors tested & determined to be operational.

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 provided.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2023
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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