Peterson Residential

Type of visit: Required - 1 Year

On 06/22/26, Licensing Program Analysts (LPA) M. Yang arrived unannounced to conduct an annual visit. LPAs introduce self, stated the purpose of the visit and request to meet with Administrator. LPA met with caregiver (S1) Ruth Patzkowsky who stated Licensee/Administrator Carol O’Donnell is unavailable to attend meeting. LPA toured facility with S1. All three 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. Knives were observed unlock in kitchen.Medications observed kept locked in laundry cabinet. MARs were reviewed and medications were checked. Fire extinguishers were observed with a service date 12/22/25. Temperature maintained for refrigerator at 37 degrees F and freezer at -8 degrees F. 2 day supplies of perishable and 7 day supplies of non-perishable food was observed. Cleaning supplies observed locked in laundry cabinet. All bedrooms were observed to have required furnishings and with adequate lighting. Bathrooms were properly equipped and operational. All bathrooms are observed with securely fastened grab bars and non-skid mats. Hot water temperature was tested at 109.1 degrees F in bathroom. Outside of facility toured and observed to be free of debris with adequate outdoor seating available for residents. Side gate observed self-closing and self-latching. All residents’ were reviewed to have all the required records. Carbon monoxide and smoke detectors were tested and observed to be operational. A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 06/29/26. Forms requested: Lic 308, Lic 500, Lic 610E, current liability insurance, and Administrator certificate. A copy of this report was provided to the caregiver, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Jun 22, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts(LPA) Rachel Bruce and Jimmy Duarte arrived unannounced to conduct the Annual inspection. LPAs met with Administrator Carol O'Donnell (AD) and explained the purpose of the visit. Facility was toured with AD. At the time of the visit, LPAs observed that all three residents were present. LPAs toured the facility with AD and observed the following: The Kitchen had working lights and well maintained appliances. The knives were kept in a locked in the laundry room. LPAs observed two trash bins with the lid. LPAs observed that refrigerator was well maintained and clean. LPAs observed a two day perishable food supply and seven day nonperishable supply. The kitchen pantry was clean, organized, and held the facility emergency supply of food. No expired food was observed. LPAs observed the dining room and living room were well lit and free of clutter and/or obstructions. Laundry room is kept locked, along with the washer and dryer there is also a locked cabinet. LPAs observed the storage cabinet to contain laundry detergents and cleaning products. Medications are stored in a separate section of this storage cabinet. First aid kit was observed and contained all required items. LPAs observed that the garage is kept locked and AD explained that residents do not have access to this room. Garage contains upright freezer for food storage. The garage is also utilized to store household chemicals. Although these chemicals were in a cabinet that can be locked away, the lock was not engaged/ AD locked it in LPAs presence. LPAs observed three cats and a cat tree and other cat items in the garage. Litter boxes were maintained and free of any odors. There is a lot of material in the garage, but accessible to access needed items. - Continued to LIC809-C Continued from LIC 809. Inspection of the living room revealed a Fireplace that was observed with glass cover. The television was observed to be in a secure place, there is also a piano and a bird cage. The living room floor was in good condition. LPAs observed one sofa and two recliners in good condition. The living room has a sliding glass door that is kept clean and is not obstructed. LPAs observed the hallway that leads to the bedrooms and observed night lights. A fire extinguisher is mounted on the wall in the hallway and one was mounted in the kitchen. Both fire extinguishers were inspected on 12/02/2024. The smoke alarm and carbon monoxide detectors were tested and are functioning appropriately. LPAs inspected the hallway bathroom with AD and observed that the bathroom is well maintained, well lit, has paper towels, toilet paper, hand soap, and a small trash bin with lid on the counter. Water temperature measured at 110.4 degrees F. The bathroom was observed to have non-skid surface, grab bars in the shower, grip bars around toilet, and a faucet. LPAs observed the linen closet to have adequate supply of clean towels, linens. Bedrooms were observed to meet regulations and were equipped with a lamp, a chair, a bed, and night stand. Closets provided appropriate storage and windows were operable with a screen in good condition. LPAs with AD inspected the backyard. LPAs, observed that the backyard is portioned off. Behind a locked gate is a koi pond and turtle pond. Patio table and bench is clean and ready for use. LPAs observed large bird cage with 10-11 birds. LPAs observed a section of the yard fenced off and locked. On the other side of the yard is the side gate which was self-closing and self-latching. However, recent weather caused the wood to swell and AD will address to ensure it remains self-latching. The side walkway that leads to the gate, has three city trash cans that partially obstruct the walkway. AD will address this as well. LPAs conducted resident and staff file reviews and found both to be in compliance. An exit interview was conducted. A copy of this report was discussed and left with AD whose signature on this form confirms receipt of these documents. Due to printer issues, the report will be emailed. LPAs are requesting the following documents be submitted to the Fresno CCL office by 04/21/2025. Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), updated facility yard sketch, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), LIC 9052the state’s words, verbatim · CDSS document, Apr 8, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Lissett Padgett arrived unannounced to conduct the Annual inspection. LPA met with care giver Ruth Patzkowsky (RP) and explained the purpose of the visit. Facility was toured with RP. Administrator (AD) Carol O'Donnell arrived later. At the time of the visit, LPA observed 4 residents in the facility. LPA with AD toured the kitchen. LPA observed that the kitchen was well maintained, with working lights and well maintained appliances. The knives were kept in a locked drawer. The kitchen counters are cluttered however was clean. LPA observed two trash bins with the lid. LPA observed that refrigerator well maintained and clean. LPA observed a 2 day perishable food supply. The kitchen pantry was clean, organized, and had an emergency supply of 124 servings of non perishable food. No expired food was observed. LPA observed the dining room is well lit. The table and can seat 4 people. Laundry room is kept locked, LPA observed the storage cabinet to contain laundry detergents and cleaning products. Medications are stored in a separate section of this storage cabinet. First aid kit was observed and contained all required items. LPA observed that the garage. The door is kept locked and RP explained that residents do not have access to this room. Garage is contains many miscellaneous items as well as hygiene items for residents. LPA observed 4 cats and a cat tree and other cat items. The garage has one upright freezer, with mostly meats. LPA inspected the living room with RP. Fireplace was observed with glass cover, television was observed to be in a secure place, piano and empty bird cage. The living room floor was in good condition. LPA observed one sofa and 2 recliners. The living room has a sliding glass door that is kept clean and is not obstructed. The furniture was clean and in good condition. LPA observed the hallway that leads to the bedrooms and observed night lights. A fire extinguisher is mounted on the wall and inspected on 11/21/2023 with the pressure gauge in good range indicated on the meter. The smoke alarm and carbon monoxide detectors were tested by the RP and are functioning. LPA observed that the thermostat is within range of the regulation at 73 degrees F. LPA inspected the hallway bathroom with RP and observed that the bathroom is well maintained, well lit, has paper towels, toilet paper, hand soap, a small trash bin with lid on the counter. Water temperature measured at 111.4 degrees F. The bathroom was observed to have non-skid mat, grab bars in shower, grip bars around toilet, and faucet. The toilet was flushed and is working. LPA observed the linen closet to have clean towels, linens. LPA inspected resident’s bedrooms with RP. LPA observed Bedroom #1 is shared. LPA observed two beds, chair, TV, 2 dressers. Window operable with screen in good condition. The smoke detector was tested and found to be functioning. Bedroom 2 is shared. LPA observed two beds, 2 dressers, desk area, closet, window operable and screen in good condition. Smoke detector tested and found to be functioning. LPA observed multipurpose room which contains exercise bike, elliptical and 4 cats a cat tree and two litter boxes. LPA with AD inspected the backyard. LPA, observed that the backyard portioned off. Behind a locked gate is a koi pond and turtle pond. Patio table and bench is clean and ready for use. LPA observed large bird cage with 10-11 birds. LPA observed a section of the yard fenced off and locked. AD opened this gate and LPA observed miscellaneous items and a shed. On the other side of the yard is the side gate was self-closing and self-latching. LPA conducted resident and staff file reviews. An exit interview was conducted. A copy of this report was discussed and left with AD whose signature on this form confirms receipt of these documents. LPA is requesting the following documents be submitted to the Fresno CCL office by 4/18/2024: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), updated facility yard sketch, Emergency and Disaster Plan (LIC 610E) Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A), LIC 9052the state’s words, verbatim · CDSS document, Apr 11, 2024