Sage Care Homes

Type of visit: Required - 1 Year

On 12/18/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Facility staff granted LPA entry to the facility and contacted staff Juanita Ruiz. Administrator arrived a short time later. LPA met with Administrator. Four residents were present during inspection. Licensee/ Administrator Merilyn Bergstrom arrived later during visit. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. Fire extinguisher was observed with a service date: 08/25/25. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature is maintained at 35 degrees F and freezer at -6 degrees F. Knives were observed locked in locked box. Cleaning supplies and chemicals stored and locked in laundry room and in the garage. Medications were observed locked in cabinet. Medication and MAR were checked and reviewed. Extra linens and towels were observed in the hall closet. All bedrooms were observed to have the required furnishings and adequate lighting. The bathrooms were toured. Non-skid mats and grabbed bars were observed. Hot water temperature was tested maintained at 113.5 and 114.3 degree F in hall bathroom and 110.5 and 111 degree F in the master bathroom. Outside of facility toured and observed to be free of debris. Adequate outdoor seating is available for residents. Side gate observed clear of obstruction. All residents’ and sample staff files were reviewed to have all required records. Smoke detectors and carbon monoxide were observed operational during visit. A deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached Lic 809D. Exit Interview conducted. The following documents are requested and to be submitted to Fresno CCL by: 12/24/25. The following updated forms were requested: Lic 500, Lic 610E, current liability insurance, current Administrator certificate, and Lic 9020. A copy of this report and appeal rights was provided to Licensee, via email.the state’s words, verbatim · CDSS document, Dec 18, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 11/21/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Facility staff granted LPA entry to the facility and contact Administrator, Merilyn Bergstrom, via telephone. Administrator arrived a short time later. LPA met with Administrator. LPA reviewed facility records and observed the following: Resident records were observed to be current and complete. Staff records were observed to be current and complete. Staff training was observed to be up to date. Emergency disaster plan reviewed and observed to be up to date. Last documented fire drill was conducted on 10/25/2024. Medications were reviewed. Facility utilizes an electronic medication administration record (MAR). Medications observed to be administered as prescribed. Facility tour conducted with Administrator. Facility observed to be clean and odor free. Common areas including the dining area observed to have adequate furnishings and lighting available. Smoke detector and carbon monoxide detector were observed to be operational. Kitchen toured. Kitchen observed to be clean and safe for food preparation. LPA observed an adequate food supply. Knives/sharps observed to be locked in a lock box inaccessible to residents in care. Cleaning supplies observed to be locked and inaccessible in the laundry room. Resident bedrooms toured. Bedrooms were observed to have required furnishings. Resident bathrooms toured. Bathrooms were equipped with securely fastened grab bars. Facility is equipped with a tank-less water heater programmed to maintain water temperature at 120 degrees F. Hot water measured at 118.0 degrees F. LPA observed an adequate supply of linens and hygiene products. Exterior tour conducted. All exits open and free from obstructions. No fire clearance issues observed during today's inspection. No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to Administrator, Merilyn Bergstrom, via email due to technical issues. Administrator informed that a hard copy of the report will be mailed to the facility. Report was signed on-site by facility representative. LPA is requesting the following documents be submitted to the Fresno CCL office by 12/05/2024: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance, Emergency and Disaster Plan (LIC 610E), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), Surety Bond*the state’s words, verbatim · CDSS document, Nov 21, 2024

Type of visit: Prelicensing

On 12/11/2023, Licensing Program Analyst (LPA) Walton arrived for an announced pre-licensing inspection. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. LPA met with Licensee, Merilyn Bergstrom. This facility is a 4 bedroom and 2 bathroom home and a fire clearance was granted for 6 Non-Ambulatory, for a total capacity of 6. LPA toured the facility. Common areas were furnished and had adequate seating and lighting available. Bedrooms had required furnishings and are ready for occupancy. Hot water measured at 118.0 degrees F in the hallway bathroom and the bathroom in bedroom 1. LPA observed an extra supply of bed linens and personal hygiene products. Kitchen was toured and observed to have dishes, plates, and utensils. Cleaning supplies and chemicals were observed to be locked and inaccessible in a closet in the laundry room. Medications will be locked in a cabinet in the office/visiting room. First aid kit was observed and contained all required items. A fire extinguisher was observed and has a service date of 10/24/2023. Smoke detectors and carbon monoxide detector were observed to be operational. Outside of facility toured. Exits were open and free of obstructions. LPA observed side gate to be self-latching. I have found that the applicant has met all pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.the state’s words, verbatim · CDSS document, Dec 11, 2023