The Golden Years III Rche

Type of visit: Required - 1 Year

On 01/15/2026, Licensing Program Analyst (LPA) M Vega arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by Staff 1 (S1). Facility Manager Noimi Bacani and Administrator (AD) - Carlo Santos was notified of Licensing visit over the phone and were able to attend the visit. LPA toured facility with Administrator Carlo Santos. The facility was observed to be at a comfortable temperature, of 75 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPA observed most residents in their rooms resting. Department phone number and infection prevention information signs were posted in facility. Restroom water temperature was tested and recorded reading of 110.8 degrees F. LPA toured facility with Administrator outside. LPA observed the back yard, fenced and in good repair. Outdoor seating area was observed in good repair and available to residents. Fire extinguisher was observed with a service date of 03/26/2025. All 6 resident bedrooms were observed to be with comfortable temperature. Medications observed to be locked in cabinets in dining area. Cleaning supplies were observed to be in a locked and inaccessible to residents. Kitchen LPA observed the required 7 day supply of non-perishable food and 2 day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. Continuation on LIC 809C 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 Facilities for the Elderly (RCFE): LIC 308 Designation of Facility Responsibility LIC 309 Administrative Organization LIC 400 Affidavit Regarding Client/Resident Cash Resources 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: 01/27/2026 As an operator of a Community Care Licensed facility it is your responsibility to be aware of and in compliance with all regulations, including Chaptered Legislation. Go to www.ccld.ca.gov to stay updated and informed. No deficiencies issued during this inspection. An exit interview was conducted with the AD A copy of this report was given to AD whose signature on this form confirms receipt of these reports.the state’s words, verbatim · CDSS document, Jan 15, 2026

Type of visit: Required - 1 Year

On 02/05/2025, Licensing Program Analyst (LPA) M Vega arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility by Staff 1 (S1). Facility Manager Noimi Bacani, Michael Bacani and Administrator Carlo Santos was notified of Licensing visit over the phone and was able to attend the visit. LPA toured facility with Administrator Carlo Santos. The facility was observed to be at a comfortable temperature, of 74 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPA observed most residents in their rooms resting. Department phone number and infection prevention information signs were posted in facility. Restroom water temperature was tested and recorded reading of 112.6 degrees F. LPA toured facility with Administrator outside. LPA observed the back yard, fenced and in good repair. Outdoor seating area was observed in good repair and available to residents. Fire extinguisher was observed with a service date of 03/22/2024. All 6 resident bedrooms were observed to be with comfortable temperature. Medications observed to be locked in cabinets in dining area. Cleaning supplies were observed to be in a locked and inaccessible to residents. Kitchen LPA observed the required 7 day supply of non-perishable food and 2 day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. Continued on LIC 809C LPA reviewed Staff and Resident files. Resident files observed to have updated information. No deficiencies were observed and cited. Exit interview conducted. Report was signed and copy of this report was provided for facility records.the state’s words, verbatim · CDSS document, Feb 5, 2025

Type of visit: Required - 1 Year

On 02/13/2024, Licensing Program Analyst (LPA) V. Gorban arrived unannounced at the above facility to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility. LPA toured facility with facility staff, Michael Bacani. Administrator (AD) Carlo Santo was notified of Licensing visit over the phone and arrived shortly to attend the visit. Facility has one entrance/exit point. LPA with staff toured facility inside and out. The facility was observed to be at a comfortable temperature, of 74 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPA observed some residents in common area after lunch watching television, others in their rooms resting. Department phone number and infection prevention information signs were posted thought the facility. Inspecting kitchen LPA observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. An emergency disaster supply was observed. Fire extinguisher was observed with a service date of 03/29/2023. All residents’ bedrooms were observed to be with comfortable temperature. Bathrooms water temperature was tested and recorded reading of 115 degrees F. Medications observed to be locked in a cabinet in the common area. LPA reviewed medication records appears to be administered properly. Cleaning supplies were observed to be in a locked cabinet in the storage it the laundry room. An outdoor seating area was observed operational for residents in care. LPA reviewed staff and residents’ files. No deficiencies were observed and cited. Exit interview conducted. A report was signed and copy of this report was provided for facility records.the state’s words, verbatim · CDSS document, Feb 13, 2024