Divine Mercy Guest Home II

Type of visit: Required - 1 Year

On 08/05/2026 , Licensing Program Analysts (LPA) J. Duarte arrived unannounced at the facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit and was allowed entry into the facility by staff Juliana Canonero. Staff contacted Administrator (AD), Ulysis Baal who arrived shortly after. Five residents were present when LPA arrived and shortly after another resident arrived. LPA toured the inside and outside of the facility with AD Ulysis. The facility was observed to be clean, odor free and at a temperature of 78 degrees F. The pathways and doors were clear and free from obstructions. Common areas were clean, adequately furnished, and adequately lit. LPA observed sufficient seating in the living room, Kitchen, and dining areas were clean and had sufficient seating. The facility had a two day supply of perishable and seven day supply of nonperishable food. Medication was observed centrally stored in a locked cabinet and and sharps were also stored in a locked cabinet. LPA toured the residents’ rooms. Resident rooms were observed to have the required furnishings. The bathroom hot water measured at 106 degrees F. Bathrooms were equipped with grab bars next to the toilet and in the shower, and the showers had non-skid mats. LPA observed chemicals locked in the restroom and in the garage. Medication and MARS were reviewed for two residents and logs were observed to be complete. Report Continued on LIC 809C. Continued from LIC 809 Laundry area toured in the garage. LPA observed a locked closet in the garage that has chemicals and detergent for laundry. The backyard was observed to have sufficient seating in the back patio. LPA observed a fenced pool in the backyard with a locked gate, inaccessible to residents. Outdoor side gate is self-closing and self-latching. Smoke detectors and carbon monoxide detectors were present and operational at the time of visit. The fire extinguisher located in the kitchen was last serviced on 07/26/2026. A fire drill was conducted on 05/23/2026, per staff records. No deficiencies were cited during inspection. Community Care Licensing (CCL) is always striving to have facility files that reflect the most accurate & up to date information for your facility. In an effort to maintain your facility file, please submit the most current & complete forms &/or information as identified below: Residential Care Facility for the Elderly (RCFE): · LIC 308 Designation of Facility Responsibility · -as applicable: LIC 309 Administrative Organization · -as applicable: LIC 400 Affidavit Regarding Client/Resident Cash Resources · -as applicable: LIC 402 Surety Bond · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan For Residential Care Facilities For The Elderly · LIC 9020 Register of Facility Clients/Residents · Copy of current Liability Insurance · Copy of current Administrator Certificate · Alternate contact information including name, telephone number, & email address. Please submit the above forms/information to Fresno CCL by: 08/12/2026 An exit interview was conducted and a copy of this report and appeal rights were discussed and provided to the Administrator, whose signature on this formthe state’s words, verbatim · CDSS document, Aug 5, 2026

Type of visit: Case Management - Other

On 05/22/26, Licensing Program Analyst (LPA) M. Yang conducted a subsequent complaint visit. LPA met with staff Teresa Cervantes and stated purpose of visit. Administrator Susan Baal was called and unable to attend meeting. Licensee authorized staff to sign report and received report. LPA returned all four residents files that were obtained. The above allegation needs further investigation at this time. Exit interview conducted. Report signed on site and a copy provided to facility.the state’s words, verbatim · CDSS document, May 22, 2026

Allegation investigated: Resident was illegally evicted .

On 08/07/2025, Licensing Program Analyst (LPA) J. Duarte conducted an unannounced visit to conduct a complaint investigation. LPA introduced self and stated the purpose of this visit and allowed entrance. LPA met with Administrator, Ulysis Baal during this visit. This Department investigated the allegation of resident was illegally evicted. Administrator Ulysis advised that the resident has not been evicted and the resident is currenlty residing in the facilty. LPA observed the resident in the facility. This Department has found that the above allegation is UNFOUNDED, meaning the allegation is false, could not have happened, and/or is without reasonable basis. We have therefore dismissed the complaint. Unfoundedthe state’s words, verbatim · CDSS document, Aug 7, 2025 · control 24-AS-20250729164726

Type of visit: Required - 1 Year

On 07/22/2025 , Licensing Program Analysts (LPA) J. Duarte arrived unannounced at the facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit and was allowed entry into the facility by staff Juliana Canonero. LPA J. Duarte contacted Administrator (AD), Susan Baal who stated she would arrive shortly. Administrator Ulysis Baal arrived shortly after LPA contacted Susan. Susan arrived shortly after Ulysis arrived. LPA toured the inside and outside of the facility with AD Ulysis. The facility was observed to be clean, odor free and at a temperature of 78 degrees F. The pathways and doors were clear and free from obstructions. Common areas were clean, adequately furnished, and adequately lit. . LPA observed sufficient seating in the living room. The Kitchen and dining areas were clean and had sufficient seating. LPA observed a seven-day supply of non-perishable foods and two-day supply of perishable foods. However, there were multiple food items in the refrigerator that were expired and/or spoiled and there were also food in containers in the refrigerator that were not labeled. LPA observed unlocked staff medication in a kitchen cabinet and in the entry office. Knives were also observed to be unlocked in a kitchen cabinet. LPA toured the residents’ rooms. Two rooms are single occupancy and two are shared. Resident rooms were observed to have the required furnishings. The bathroom hot water measured at 105.4 degrees F. Bathrooms were equipped with grab bars next to the toilet and in the shower, and the showers had non-skid mats. LPA observed bleach unlocked in a cabinet in the hallway bathroom. Medication and MARS were reviewed for two residents and logs were observed to be complete. Report Continued on LIC 809C. Continued from LIC 809 Laundry area toured in the garage. LPA observed a locked closet in the garage that has all chemicals. The backyard was observed to have sufficient seating in the back patio. LPA observed a fenced pool in the backyard with a locked gate. Outdoor side gate is self-closing and self-latching. Smoke detectors and carbon monoxide detectors were present and operational at the time of visit. The fire extinguisher located in the kitchen was last serviced on 06/05/2025. A fire drill was conducted on 06/25/25, per staff records. Deficiencies are being cited in accordance with the California Code of Regulations, Title 22, Division 6 on the attached LIC 809D. LPA requested the following documents to be submitted to CCL by 07/28/2025: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610E), Affidavit regarding Resident Cash Resources (LIC 400), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) to update the facility file. An exit interview was conducted, and a plan of correction was reviewed and developed with the administrators. A copy of this report and appeal rights were discussed and provided to the Administrator, whose signature on this formthe state’s words, verbatim · CDSS document, Jul 22, 2025

Type of visit: Required - 1 Year

On 9/5/2024, Licensing Program Analysts (LPA) K.Kaur arrived at the facility unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit and was allowed entry into the facility by staff Justin D. Clemeno. Facility Staff contacted Administrator/Licensee, Susan Baal and Ulysis Baal. Licensees arrived a short time later. LPA toured the facility inside and out with staff. Facility observed to be clean, odor free and at a comfortable temperature. Pathways and doors were clear and free from obstruction. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. LPA observed sufficient seating in living room. Fire extinguisher last serviced 3/18/2024. LPA toured 4 resident rooms. Two rooms are single occupancy and two are shared. Resident rooms observed to have the required furnishings. At 11:41 AM LPA observed Bedroom Window was missing a screen. Tour continued to Kitchen and dining area which were clean and had sufficient seating. LPA observed 7-day supply of non-perishable foods and 2-day supply of perishable foods. At 11:46 AM LPA observed unlocked medication in the refrigerator. Laundry area toured in the garage. LPA observed locked closet in the garage that has all chemicals. At 12:01 PM LPA observed Ajax container in the hallway bathroom next to the toilet. The exterior tour was conducted. The backyard was observed to have sufficient space and shade under a patio. Licensee states furniture is available for patio when weather is better. At 12:14 PM LPA observed unlocked paint cans in the storage shed. Backyard gate is self-closing and self-latching. Resident's records contained signed Admission Agreement, Personal Rights, and current Physician's Report and ID Documentation. At 2:10 PM LPA observed no residents had Appraisal needs and service plans. Staff files were reviewed for good health and CPR/First Aid. At 2:51 PM LPA reviewed Centrally Stored Medication and Destruction Record (CSMDR) lists, MAR(s) and medication and observed 5 medications from two residents were not logged in the log. Continued to Next Page Deficiencies are being cited in accordance with California Code of Regulations, Title 22, Division 6 on the attached 809D. LPA requested the following documents to be submitted to CCL by 9/19/2024: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610E), Affidavit regarding Resident Cash Resources (LIC 400), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Exit interview conducted and a plan of correction was reviewed and developed with Licensee/Administrator. A copy of this report and appeal rights was discussed and provided to Administrator, whose signature on this form confirms receipt of this document.the state’s words, verbatim · CDSS document, Sep 5, 2024

The state marks this report as 8 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.