Devoted Home Care

Type of visit: Required - 1 Year

On 03/18/26, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and met with staff Lourdes Morgan. Administrator(A1) Petro Crisostomo was called and arrived shortly during visit. LPA toured facility with A1. Five residents were present during the inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. All residents’ files were reviewed to have required documents. Medications were checked and observed locked medication cart and kitchen shelf. Residents’ MARS, medications, and Centrally Stored Medication Records were reviewed. Fire extinguisher was observed with a service date of: 02/03/26. An adequate supply of perishable and non-perishable food was observed. Freezer temperature was maintained at 0 degree F and refrigerator temperature maintained at 44 degrees F. Knives observed locked in kitchen drawer. First Aid box lock on the kitchen wall with required items. Washer and dryer observed functional and operational during visit. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are observed with securely fastened grab bars and non-skid mats. Hot water temperature was tested range at 119.8 and 118.9 degrees F in master bathroom and 120 degrees F in hall bathroom.Outside of facility toured and observed free of debris. Side exit observed with no obstructions. Carbon monoxide and smoke detectors were tested and observed to be operational. All staff files and half of residents’ files were reviewed to have all required documents. No deficiency cited during visit. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 03/24/26. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, current Administrator Certificate, and current liability insurance. A copy of this report was provided to Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Mar 18, 2026

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 04/02/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and met with Administrator(A1) Petro Crisostomo. Upon arrival audio video camera monitor observed in the common area. LPA toured facility with A1. All five residents were present during the inspection. Three residents were observed sitting in the living room and two in the bedrooms. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. All residents’ files were reviewed to have required documents. Medications were checked and observed unlocked medication cart and kitchen shelf. Residents’ MARS and Centrally Stored Medication Records were reviewed. Fire extinguisher was observed with a service date of:03/03/25. Last fire drill completed on 01/10/25. An adequate supply of perishable and non-perishable food was observed. Freezer temperature maintained at 0 degree F and refrigerator temperature maintained at 44 degrees F. Knives observed locked in kitchen drawer. LPA observed over-the-counter medications stored in First Aid box unlock on the kitchen wall. Washer and dryer observed functional and operational during visit. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are observed with securely fastened grab bars and non-skid mat. Hot water temperature was tested range at 118.9 and 117.7 degrees F in master bathroom and 118.9 degrees F in hall bathroom. Outside of facility toured and observed free of debris. Side exit observed with no obstructions. Carbon monoxide and smoke detectors were tested and observed to be operational. A sample of staff files were reviewed to have all required documents. Carbon monoxide and smoke detector operational during visit. Technical Support Program (TSP) assistance was offered to Administrator. Administrator will make a decision and reach out the department regarding acceptance. A deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached Lic 809D. A civil penalty is being assessed see attached Lic 421IM. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 04/08/25. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, current Administrator Certificate, and current liability insurance. A copy of this report and appeal rights was provided to Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Apr 2, 2025

The state marks this report as 8 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 04/12/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit. introduce self, stated the purpose of the visit and met caregiver Jane “Jackie” Corral. LPA toured facility with caregiver. Licensee/Administrator Petro Crisostomo was called and arrived shortly during tour. All five residents were present during inspection. 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. Medications were observed locked in medication cart in the dining area. MARs were reviewed. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature is maintained at 40 degrees F and freezer at 0 degrees F. Fire extinguisher was observed with a service date of: 01/29/24. Cleaning supplies and chemicals stored and locked in garage and laundry room. Dryer observed operational during inspection. All bedrooms were observed to have the required furnishings and with adequate lightening. The bathrooms were toured and observed operational during inspection. Non-skid mat and grabbed bars were observed. Hot water temperature was tested range at 108 and 109.4 degrees F in master bathroom and 119.4 degrees F in bathroom. Extra linens were observed. All residents and sample of staff files were observed with the required documents. Outside of facility toured and observed to be free of debris. 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 submitted to Fresno CCL by: 4/18/24. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, current liability insurance, current Administrator certificate, and control of property. A copy of this report and appeal rights was provided to Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Apr 12, 2024