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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547209487
Report Date: 12/04/2024
Date Signed: 12/04/2024 11:12:17 AM

Document Has Been Signed on 12/04/2024 11:12 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:HILLCREST LIVING CENTERFACILITY NUMBER:
547209487
ADMINISTRATOR/
DIRECTOR:		CHEHAL, KIRANFACILITY TYPE:
740
ADDRESS:3939 E. HILLCREST AVETELEPHONE:
(559) 289-9108
CITY:VISALIASTATE: CAZIP CODE:
93292
CAPACITY: 6CENSUS: 0DATE:
12/04/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:35 AM
MET WITH:Licensee Kanwar Singh and Licensee Kiran ChehalTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On 12/04/24, Licensing Program Analyst (LPA) Yang arrived to the facility announced to conduct the Pre
licensing visit. LPA Yang met with Licensee (L1) Kanwar Singh and Licensee 2 (L2) Kiran Chehal who granted LPA entry into the facility.

The facility is a 4 bedroom, and 2 bathroom home and fire clearance were granted for 6 Ambulatory for a total capacity of 6. There are no clients present during this inspection. LPA toured the facility with L1 and L2. A fire extinguisher was observed with a purchase date 05/10/24. Facility was free from ground obstructions and odor free. Common areas were observed to have adequate seating and lighting available. Kitchen was toured and observed to have dishes, plates, and utensils. Knives kept locked in kitchen shelf. Medications will be kept locked in kitchen shelf. Refrigerator temperature maintained at 39.2 degrees F and freezer temperature maintained at 0 degrees F. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. Cleaning supplies and chemicals was locked in a garage cabinet. LPA observed an extra supply of bed linens and personal hygiene products.

Bedrooms were observed to have the required furnishing and are ready for occupancy. Bathrooms tour. LPA observed grabbed bars and non-skid mats. Hot water temperature tested at 108.1 degrees F, ranged between 105.8 and 107.1 degrees F in master bathroom. Outside of facility toured. Adequate outdoor seatings available for resident. LPA observed exit side gate to be self-latching and free of debris. Smoke detectors and carbon monoxide were observed to be operational during this inspection.

Facility phone number is (559)667-4355.

Component III was conducted during pre-licensing visit with Applicants. I have found that applicant has met all Pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to
license being issued.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
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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