Illustration — no photo of this home on file yet
Sierra Palace for Elderly
Small home·Licensed for 6·Fresno, California
- Care approvals on fileWheelchair · HospiceState licensing record · September 13, 2026
- Typical starting rate$4,000 a monthTypical in Fresno County · likely $2,950–$5,500
- Home sizeLicensed for 6Small care home · a licensed care home (RCFE)
- Room at the last state visit6 of 6 beds occupiedFebruary 23, 2024 · not a current opening
- Ways to payAsk the homeMedi-Cal ALW participation not on file
- Last state visitFebruary 10, 2026CDSS inspection record
Sierra Palace for Elderly is a small care home in Fresno — a licensed residential care facility for the elderly (RCFE), the licence category behind “assisted living” and “board and care.” It is licensed for 6 residents since 1997. Dementia care and bedridden care are not on file.
Built from CDSS public records · September 13, 2026. Every fact below names its source and date.
Quick answers and the state record
A citation does not make a home unsafe, and an empty file does not make a home good.
Quick answers about Sierra Palace for Elderly
Is Sierra Palace for Elderly licensed?
The state lists this license as “Licensed/Pending Increase,” per CDSS records as of September 13, 2026.
How many residents is Sierra Palace for Elderly licensed for?
6 residents — a small home, per CDSS records as of September 13, 2026.
Has Sierra Palace for Elderly been cited?
0 Type A and 3 Type B citations since 1997, per CDSS records as of September 13, 2026. Those records count 14 state visits over the same years.
Is Sierra Palace for Elderly still open?
This license was on the CDSS roster as of May 25, 2025.
What does Sierra Palace for Elderly cost?
$4,000 a month to start is typical in Fresno County, likely $2,950–$5,500. This home’s own rate is not on file. Ask: “What is the all-in monthly rate, and what would push it higher?”
Too few nearby homes publish a rate, so this is the typical starting rate 5 small homes publish in Fresno County, with a wider likely range. This home’s own rate is not on file.
Among 5 other homes of a similar licensed size in Fresno that publish a starting rate, the middle half runs $3,450 to $5,175 a month, and the middle figure is $4,000 (n = 5 other homes publishing a starting rate).
Each of those is a home’s own published figure, gathered on its own date in September 2026 — not an average of ours, and not a survey. Similar size means small and mid-size homes counted together, and large communities counted on their own, because they are different markets.
A home outside the band is not overcharging or underpricing: a starting rate covers different things in different homes, which is the first thing to ask about.
The price is made in the phone call. Nothing here is a quote, an offer or a discount.
A starting rate is the room and the base care. California homes commonly bill care levels, medication management, supplies, transport and a second person in the room as extras. Many also charge a one-time fee at move-in. Ask for that list in writing before anything is signed.
Only prices a home put out itself count here: its own website, a listing it supplied, or a price a listing site says the home confirmed. Prices a site shows without saying where they came from are left out.
Does Sierra Palace for Elderly take Medi-Cal?
On Medi-Cal’s Assisted Living Waiver: this home is not on the DHCS participation list dated September 23, 2026. Ask the program about current options. The waiver pays for care services, not room and board.
Who holds the license?
The license is held by Perera, Neil, per CDSS records as of September 13, 2026.
Is there a hospital nearby?
Fresno Surgical Hospital is 0.5 miles away in a straight line, per the CDPH licensed-hospital list dated September 16, 2026. See licensed care homes near it.
Can Sierra Palace for Elderly keep a resident on hospice?
Hospice care is approved on this license, per CDSS records as of September 13, 2026.
Sierra Palace for Elderly license and inspection record
- Name on the license: “SIERRA PALACE FOR ELDERLY”, per the CDSS roster as of May 25, 2025.
- License #107200486. The state lists this license as “Licensed/Pending Increase,” per CDSS records as of September 13, 2026.
- Licensed for 6 residents — a small home, per CDSS records as of September 13, 2026.
- Licensed to Perera, Neil, per CDSS records as of September 13, 2026.
- First licensed in 1997, per CDSS records as of September 13, 2026.
- 14 state inspection visits since 1997, per CDSS records as of September 13, 2026.
- 0 Type A and 3 Type B citations on file since 1997, per CDSS records as of September 13, 2026. The same records count 14 state visits in that period.
- 4 complaints and 3 substantiated allegations on file since 1997, per CDSS records as of September 13, 2026. One complaint can carry several allegations.
- The most recent state visit on file is February 10, 2026, per CDSS records as of September 13, 2026.
California writes these definitions for every licensed home, not for this one. CDSS citation definitions (PDF) ↗
Can they support the care needed?
California licenses a home for specific kinds of care. The state’s record lists what this home is approved for; the home’s own answers fill in what changes as needs change.
- Wheelchair / non-ambulatoryApproved · covers up to 6 residents
- Dementia / memory careNot on file · ask the home
- Hospice careApproved by the state
- BedriddenNot on file · ask the home
State licensing record · September 13, 2026. An approval may cover specific rooms or residents; it does not establish an opening.
Read the state’s own wording
AGE 60 AND OVER. ALL MAY BE NON AMBULATORY. HOSPICE WAIVER APPROVED FOR ONE(1). DEVELOPMENTALLY AND MENTALLY DISABLED RESIDENTS.
920 - DEVELOPMENTALLY / MENTALLY DISABLED (DD/MD)
CDSS record, verbatim · September 13, 2026
As needs change
- Staying through hospice
Hospice waiver on file — care may continue at the end of life
Ask: “If hospice is needed, can care continue here until the end?”
State licensing record · September 13, 2026
4 more questions to ask the home
- Two-person transfers or a lift
Not on file
Ask: “If two people or a lift are needed to transfer, can the person stay?”
- Someone awake overnight
Not on file
Ask: “Who is awake overnight, and how do residents ask for help?”
- Medicines
Not on file
Ask: “Who manages the medicines, and what happens when a dose is missed?”
- If memory loss develops
Dementia-care designation not on file
Ask: “If memory loss develops, what would change — and when would a move be needed?”
What it costs here
Typical starting rate
$4,000a month to start
Likely $2,950–$5,500
From homes this size in Fresno County · this home’s rate is not on file
Likely monthly total
$4,000a month
Likely $2,950–$5,650
With a shared room and basic help.
An estimate for planning, not a quote. The price is made in the phone call.
See the full cost breakdownRoom, care and fees · how people pay · how this estimate works
Memory care is not priced here: a dementia-care designation is not on file for this home. Ask the home.
Starting monthly rate$4,000likely $2,950–$5,500
Too few nearby homes publish a rate, so this is the typical starting rate 5 small homes publish in Fresno County, with a wider likely range. This home’s own rate is not on file.
Basic help with daily careUsually includedup to $600
Basic help is usually part of the starting rate. Homes that price care by level start around $600 a month (45 California homes publish a care-level range, seen in September 2026).
One-time move-in fee$2,000one time · likely $0–$4,000
Homes that list a one-time entry or community fee charge a median of $2,000 (134 California listings; middle half $1,000–$4,000). Many homes list none — ask.
- Likely monthly totalLikely $2,950–$5,650
- $4,000
- First monthWith a one-time move-in fee · likely $3,700–$8,600
- $6,000
How people payPrivate pay, Medi-Cal waiver, SSI/SSP, veterans, insurance
- Private payMost residents pay from savings, a home sale or family help. Ask for the rate and what it includes in writing.
- Medi-Cal Assisted Living WaiverThis home is not on the DHCS participation list dated September 23, 2026. Ask the program about current options. The waiver pays for care services, not room and board.
- SSI/SSPCalifornia’s 2026 standard is $1,626.07 a month; $1,444.07 of it goes to the home and $182 stays with the resident. Whether this home accepts it is not on file — ask.
- VeteransVA Aid & Attendance can add to a veteran’s or surviving spouse’s pension. Ask whether residents here have used it.
- Long-term care insuranceMost policies pay for licensed care homes. Ask what paperwork the home provides for claims.
- MedicareDoes not pay for room and board in a care home. It can still cover hospice or home-health visits inside one.
Avoid surprises on the billWhat changes the price, and what to ask
- The care level
Some homes charge one all-inclusive rate. Others add levels or points as needs grow. Ask how the level is set, who decides, and what the next level costs.
- What is billed separately
Medication management, incontinence supplies, transportation and a second person in the room are often extra. Ask for the list in writing.
- Move-in costs
A one-time community fee or deposit is common. Ask what it covers and whether any of it comes back if the stay is short.
- Increases
California requires at least 90 days’ written notice, with reasons, before a rate rises (Health & Safety Code §1569.655). A change in the resident’s care level is the section’s own exception and can be billed sooner.
- What is the full monthly cost for the room and care we need, and what does it include?
- What would the next care level cost, and who decides when it changes?
- What is billed separately, and is there a one-time fee or deposit at move-in?
- Is any private-pay period required before another payment program can begin?
How this estimate worksWhy this is a county figure
Too few nearby homes publish a rate, so this is the typical starting rate 5 small homes publish in Fresno County, with a wider likely range. This home’s own rate is not on file.
- Only prices a home put out itself count: its own website, a listing it supplied, or a price Seniorly says the home confirmed. Prices a listing site shows without saying where they came from are left out.
- Nearby homes are the nearest of the same size that publish a rate, widening from 3 to 40 miles until at least 8 do. The estimate starts from what they charge, then adjusts for this home’s size, state care approvals, Medi-Cal waiver participation, years licensed and the area’s prices.
- Room, care-level, second-person and move-in lines come from what California homes publish on listing sites. Memory care uses Covelight’s researched premium over assisted living.
- Totals add each line’s figure and combine the lines’ ranges as separate charges, because a home is rarely at the top, or the bottom, of every line at once.
- We tested this estimate on 1,546 California homes that publish their own starting rate. It was within 10% of the real rate for 3 in 10 homes and within 25% for 7 in 10; the likely range held the real rate for 6 in 10 (September 12, 2026).
- It cannot see this home’s specials, how it assesses care, or which rooms are open.
Show the 7 nearby homes that publish a rate
- Palo Alto Senior Care HomeFresno · 1.1 mi · Small home$3,000Listed on Seniorly · assisted living · seen September 9, 2026
- Joyful Living RcheFresno · 2.3 mi · Small home$3,600Listed on Seniorly · assisted living · seen September 9, 2026
- Green VillaFresno · 2.3 mi · Small home$5,000Listed on Seniorly · assisted living private room · seen September 9, 2026
- Carmel Village Memory CareClovis · 5.2 mi · Mid-size home$6,000Listed on Seniorly · independent living private cottage/casita · seen September 9, 2026
- Serenity Garden Home 2Fresno · 8.0 mi · Small home$4,000Listed on Seniorly · seen September 9, 2026
- Close to Home Residential CareFresno · 9.4 mi · Small home$5,700Listed on Seniorly · assisted living shared bedroom · seen September 9, 2026
- The Harvest at FowlerFowler · 15 mi · Mid-size home$3,000Listed on AssistedLiving.com · seen September 9, 2026
Where it is
- 607 E. Sierra Avenue, Fresno, CA 93710Address from the public record · September 13, 2026. Confirm the entrance with the home before visiting.
Opening the neighborhood map…
The state record
California inspects every licensed home and publishes what it found. Here are the dated documents and the state’s own words, beside what is typical for homes this size.
Since 2021, the state has filed 13 documents for this home, and its records count 14 visits since 1997. The most recent is a facility evaluation report, dated February 10, 2026.
- On file since
- 2021
- State visits
- 14
- Most recent visit
- February 10, 2026
- Occupied · February 23, 2024 visit
- 6 of 6 bedsa count on that day, not an opening
We hold 6 complaint reports the state published for this home, dated December 14, 2021 to February 23, 2024. 6 of the 6 carry the state's recorded outcome word: “Substantiated” (2), “Unfounded” (2), “Unsubstantiated” (2). 6 include the transcribed allegation the state investigated, word for word. Summary composed by computer from the 6 complaint reports below — every count derives from them, and the documents themselves are the state's records, verbatim. We never grade, score, or color a record.
Beside homes the same size
- Type A citations0typical 0
- Type B citations3typical 0
- Substantiated allegations3typical 0
- Total complaints4typical 0
“Typical” is the statewide median across the 6,808 licensed small board-and-care homes (6 or fewer beds) in the state record — larger, longer-licensed homes accumulate more visits and reports, so compare like with like. One complaint can contain several allegations. Counts cover this licence since 1997.
Year by year
The last 36 months — 6 of 13 documents
Feb 10, 2026Facility evaluation reportReport on file
Type of visit: Required - 1 Year
Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility unannounced to conduct a required Annual visit. LPA explained the purpose of the visit and was granted entry by caregiver staff (S1) Vanessa Quinonez. A phone call was placed to House Manager, Virginia Jimenez (S2), who later arrived at the facility. This annual visit was completed with S1 and S2, as approved by Administrator, Elizabeth Perera. The residence was set at 77 degrees F temperature and free of passageway obstructions inside and outside. LPA observed resident bedrooms, only 4 are currently occupied. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured to be between 110 and 118.6 degrees F. Home has two hot water heaters. Kitchen toured, supply of food observed, and food stored properly for perishable and nonperishable. Knives are kept locked in the kitchen area. Medication is kept locked in the medication storage office. Cleaning supplies were locked in the laundry room and storage room. Smoke and carbon monoxide detectors were observed. Fire sprinkler system is a pull alarm tested by Reliable Alarm certified on 4/28/25. Fire extinguishers were charged on 12/18/2025. First Aid kit is fully equipped and kept in the kitchen area. Last fire drill was on 2/7/2026. Disaster Plan and Infection Control Plan was reviewed with S2. Outdoor area was clean and free of obstruction. An exit interview was conducted, and a copy of this report was provided to S2 whose signature confirms receipt. LPA requested the following updated forms faxed to CCLD by 02/20/2026: Personnel Report (LIC 500), Proof of current Liability Coverage.the state’s words, verbatim · CDSS document, Feb 10, 2026
Feb 11, 2025Facility evaluation reportReport on file
Type of visit: Required - 1 Year
Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility unannounced to conduct a required annual visit. LPA explained the purpose of the visit and was granted entry by caregiver staff (S1) Vanessa Quinonez. A phone call was placed to House Manager, Virginia Jimenez (S2), who later arrived at the facility. This annual visit was completed with S1 and S2, as approved by Administrator, Elizabeth Perera. The residence was set at 77 degrees F temperature and free of passageway obstructions inside and outside. LPA observed resident bedrooms, only 4 are currently occupied. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured at 120 degrees F. Home has two hot water heaters. Kitchen toured, supply of food observed, and food stored properly for perishable and nonperishable. Knives are kept locked in the kitchen area. Medication is kept locked in the medication storage office. Cleaning supplies were locked in the laundry room and storage room. Smoke and carbon monoxide detectors were observed, they were checked and operating. Fire extinguisher was charged and was serviced on 12/06/2024. First Aid kit is fully equipped and kept in the kitchen area. Outdoor area was clean and free of obstruction. An exit interview was conducted, and a copy of this report was provided to S2 whose signature confirms receipt. LPA requested the following updated forms faxed to CCLD by 02/18/2025: Personnel Report (LIC 500), Proof of current Liability Coverage.the state’s words, verbatim · CDSS document, Feb 11, 2025
Feb 23, 2024Complaint investigation reportUnsubstantiated
Allegation investigated: Staff force residents to shower
Licensing Program Analyst (LPA) M. Flores arrived at the facility unannounced for subsequent complaint inspection. LPA discussed the purpose of the visit and the elements of the allegations with House Manager, Lisa Luna. Administrator, Elizabeth gave a verbal consent for this LPA to have this inspection with House Manager, Lisa Luna. LPA delivered the following findings: During this visit LPA delivered investigation findings regarding the above allegation. The Department has investigated the complaint alleging: Staff force residents to shower. Based on the interviews conducted and records reviews the above allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted and a copy of this report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Feb 23, 2024 · control 24-AS-20231213150724
Feb 23, 2024Complaint investigation reportUnfounded
Allegation investigated: Staff do not transport residents to hospital as needed Staff force residents to attend day program
Licensing Program Analyst (LPA) M. Flores arrived at the facility unannounced for subsequent complaint inspection. LPA discussed the purpose of the visit and the elements of the allegations with House Manager, Lisa Luna. Administrator, Elizabeth gave a verbal consent for this LPA to have this inspection with House Manager, Lisa Luna. LPA delivered the following findings: During the course of this investigation LPA reviewed facility files and completed interviews relevant to the complaint investigation. It was determined that the above allegations: Staff do not transport residents to hospital as needed and Staff force residents to attend day program are UNFOUNDED. This agency has investigated the complaint alleging, Staff do not transport residents to hospital as needed and Staff force residents to attend day program. We have found that the complaint was unfounded, therefore we have dismissed the allegations. An exit interview was conducted and a copy of this report was provided. Unfoundedthe state’s words, verbatim · CDSS document, Feb 23, 2024 · control 24-AS-20231213150724
Feb 23, 2024Complaint investigation reportSubstantiated
Allegation investigated: Staff do not provide the proper resources to residents in care
Licensing Program Analyst (LPA) M. Flores arrived at the facility unannounced for subsequent complaint inspection. LPA discussed the purpose of the visit and the elements of the allegations with House Manager, Lisa Luna. Administrator, Elizabeth gave a verbal consent for this LPA to have this inspection with House Manager, Lisa Luna. LPA delivered the following findings: LPA, M. Flores conducted the subsequent complaint investigation visit to the facility. During the course of this complaint investigation. LPA interviewed staff on duty, obtained and reviewed facility records. It was determined based on the interviews and records review that the above allegation is SUBSTANTIATED. Staff do not provide the proper resources to resident in case. Based on evidence, facility did not have the proper personnel to meet the needs of R4 per needs identified in the care plan. Based on LPA’s observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. Continue 9099D Substantiated California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 23, 2024 · control 24-AS-20231213150724
From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(a) · Plan of correction due date: Feb 23, 2024
(a) Facility personnel shall... be sufficient in numbers...to provide the services necessary to meet resident needs... provide additional staff whenever it determines through documentation that the needs of...residents...This requirement was not met as evidenced by The Licensee did not ensure that the facility was equipped to provide the 1 on 1 staffing for R4, as agreed on the Individual Program Plan dated 10/17/23. This poses a potential Health and Safety risk to person in care.the state’s words, verbatim · CDSS document, Feb 23, 2024
Plan of correction: Licensee has implemented a new staff schedule to meet the one-on-one requirements as stated in the IPP for R4 as of January 1, 2024.
Dec 18, 2023Facility evaluation reportReport on file
Type of visit: Required - 1 Year
Licensing Program Analyst (LPA) M. Flores arrived at the facility unannounced to conduct a required annual visit. LPA explained the purpose of the visit and was granted entry by staff and House Manager, Rosa Guzman (S1). A few minutes later, House Manager, Virginia Jimenez (S2) arrived at the facility. This annual visit was completed with S1 and S2, as approved by Administrator, Elizabeth Perera. The residence was set at 77 degrees F temperature and free of passageway obstructions inside and outside. LPA observed six bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured at 107.7 degrees F. Kitchen toured, supply of food observed, and food stored properly for perishable and nonperishable. Knives are kept locked in the kitchen area. Medication is kept locked in the medication storage office. Cleaning supplies were locked in the laundry room and storage room. Smoke detectors and carbon monoxide are dual detectors, they were checked and operating. Fire extinguisher was charged and was serviced on 9/06/2023. First Aid kit is fully equipped. There was outdoor seating for the residents. Outdoor area was clean and free of obstruction. An exit interview was conducted, and a copy of this report was provided to S2 whose signature confirms receipt. LPA requested the following updated forms faxed to CCLD by 12/22/23: Designation of Facility Responsibility (LIC308), Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage.the state’s words, verbatim · CDSS document, Dec 18, 2023
The state marks this report as 6 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.
What the state’s words mean
CDSS citation definitions (PDF) ↗ · CDSS complaint outcomes ↗
Life here
Rooms, meals, the rhythm of a day, faith and language, pets and house rules — as the home describes them. Tap any detail for its source and date; nothing here is graded.
The home has not described daily life anywhere we have reviewed yet — that is the case for most small homes, and it says nothing about the home. These questions fill in the picture; keep the ones that matter to you.
Before you call
Ask every home the same questions — the state’s record does not answer these. Keep the ones that matter and they travel with your saved homes.
- What is included in the monthly rate, and what costs extra?
- Who is awake overnight, and how do residents ask for help?
- Which rooms does the non-ambulatory approval cover, and what transfer support is provided?
- What could change whether someone can stay here?
- Can we see a bedroom and share a meal during a visit?
Other homes nearby
The nearest licensed homes in Fresno County, closest first. Every listed home appears on the same terms.
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Dial for Care #3
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The Terraces at San Joaquin Gardens
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Heart to Heart Family Care Center
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Rose Meadow Manor
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$4,000 a month to start · Typical in Fresno County
Dial for Care Inc.
Fresno · Small home · 0.9 mi away
$4,000 a month to start · Typical in Fresno County