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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209386
Report Date: 09/15/2026
Date Signed: 09/15/2026 05:21:28 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 09/15/2026 05:21 PM - It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:RADIANCE SENIOR CAREHOMEFACILITY NUMBER:
107209386
ADMINISTRATOR/
DIRECTOR:		BAUTISTA, ARLENEFACILITY TYPE:
740
ADDRESS:707 W CHENNAULT AVE.TELEPHONE:
(559) 704-6796
CITY:CLOVISSTATE: CAZIP CODE:
93611
CAPACITY: 6CENSUS: 6DATE:
09/15/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH: Administrator/ Licensee (L1) Arlene Bautista and Assistant Administrator (S1) Elisa “Lisa” Pua TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 09/15/26, Licensing Program Analysts (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduced self, stated the purpose of the visit and requested to meet with Administrator. LPA met with staff Ferdinand “Jay” Maglalang. Administrator/ Licensee (L1) Arlene Bautista and Assistant Administrator (S1) Elisa “Lisa” Pua was called arrived shortly during inspection. LPA toured facility with L1. Four residents were present during inspection. Two residents observed sitting at the dining table and two residents observed in the bedroom 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. All residents and all staff files were reviewed. LPA observed 2 day supplies of perishable and 7 day supplies of non-perishable food. Refrigerator observed maintained at 37 degree F and freezer maintained at 0 degree F.

Expired perishable food observed in the refrigerator. Knives were observed stored under the kitchen counter unlocked. Cleaning supplies observed stored and under the kitchen sink unlock. Medications observed kept locked in kitchen shelves and in lockbox in the refrigerator. Medications were checked, MARS, and centrally stored medication list were reviewed. Fire extinguishers were observed one by the front door with a purchase date of 04/3/26. Last fire drill was completed on 07/25/26. All bedrooms were observed to have required furnishings and with adequate lighting.

All bathrooms were toured. LPA observed with securely fastened grab bars and non-skid mats. R1 was observed laying down in bed with full bed rails. Bathrooms observed functioning and operating during inspection. Hot water temperature was tested observed maintained at 113 degrees F in hall bathroom and at 113.3 and 113.1 degree F in the master bathroom. Extra linens and towels were observed in the hall closet.

(Continued to Lic 809C)

See Moua
Mai Yang
DATE: 09/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: RADIANCE SENIOR CAREHOME
FACILITY NUMBER: 107209386
VISIT DATE: 09/15/2026
NARRATIVE
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(Continued from Lic 809)

Outside of facility toured and observed to be free of debris with adequate outdoor seating available for residents. Side gates were observed self-closing and self-latching. 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 see attached 809D.

Exit Interview conducted. LPA received updated copies of: Lic 308, Lic 500, Lic 610E, current liability insurance, and current Administrator certificate. A copy of this report and appeal rights were provided to the Licensee, whose signature on this form confirms receipt of this report.

NAME OF LICENSING PROGRAM MANAGER: See Moua
NAME OF LICENSING PROGRAM ANALYST: Mai Yang
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2026
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 09/15/2026 05:21 PM - It Cannot Be Edited


Created By: Mai Yang On 09/15/2026 at 03:22 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: RADIANCE SENIOR CAREHOME
FACILITY NUMBER: 107209386

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/16/2026
Section Cited
CCR
87555(b)(8)

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87555(b)(8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state, and local authorities...

This requirement is not met as evidenced by:
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Administrator disregarded expired food. POC cleared during visit.
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Based on observation, expired perishable food was observed in the refrigerator, poses/posed an immediate health, safety or personal rights risk to persons in care.
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Type A
09/16/2026
Section Cited
CCR87309(a)

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87309(a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.

This requirement is not met as evidenced by:
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Licensee immediately locked chemicals, knives, and tool. POC cleared during visit.
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Based on observation and interview conducted, the licensee did not comply with the section cited above when LPA and L1 observed knives unlock under the kitchen cabinet, chemicals unlock under the kitchen sink and a plier unlock in the dining cabinet accessible to residents in care this poses an immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
See Moua
NAME OF LICENSING PROGRAM MANAGER:
Mai Yang
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2026


LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 09/15/2026 05:21 PM - It Cannot Be Edited


Created By: Mai Yang On 09/15/2026 at 03:23 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: RADIANCE SENIOR CAREHOME
FACILITY NUMBER: 107209386

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/25/2026
Section Cited
CCR
87463(a)

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87463 (a)...Pre-Admission Appraisal, shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first..., referred to as the reappraisal.

This requirement is not met as evidenced by:
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Licensee shall ensure that all residents have the required records on file. R1, R3, R4, R5 and R6’s Lic 603A and Lic 625 will be completed and submitted the Fresno CCL office by POC due date 09/25/26.
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Based on records reviewed, five out of six residents’ appraisals and needs and services plan were observed last updated longer than one year, poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
09/30/2026
Section Cited
CCR87623(b)(2)(B)

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87623 (b)(2)(B) There shall be written documentation by an appropriately skilled professional outlining the instruction of the procedures delegated and the names of the facility staff who have been instructed.

This requirement is not met as evidenced by:
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Licensee will submit a Restricted Health Condition Care Plan for R1 to Fresno CCL by POC due date 09/30/26
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Based on interview conducted, observation, and records reviewed, R1 has a restricted health conditions use of catheter by home health with no restricted health condition care plan on file or in placed, poses/posed a potential health and safety and personal rights risk to the resident in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
See Moua
NAME OF LICENSING PROGRAM MANAGER:
Mai Yang
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/15/2026 05:21 PM - It Cannot Be Edited


Created By: Mai Yang On 09/15/2026 at 03:26 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: RADIANCE SENIOR CAREHOME
FACILITY NUMBER: 107209386

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/18/2026
Section Cited
CCR
87633(b)

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87633(b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident…

This requirement is not met as evidenced by:
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Licensee obtained R2 and R3’s current hospice care plan during visit from hospice agency. POC cleared during visit.
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Based on records review, the licensee did not comply with the section cited above when LPA and L1 reviewed R2 and R3’s file, whose currently receiving hospice care with no current hospice care plan on file, which poses a potential health or personal rights risk to persons in care.
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Type B
09/30/2026
Section Cited
CCR87608(a)(5)(B)

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87608(a)(5)(B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails.

This requirement is not met as evidenced by:
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Licensee stated R1’s full rails will be removed by POC due date 09/30/26.
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Based on observation and records reviewed, R1 whose not receiving hospice care was observed lying bed using a hospital bed with full rail, which poses/posed a potential health and safety and personal rights risk to the resident in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
See Moua
NAME OF LICENSING PROGRAM MANAGER:
Mai Yang
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2026


LIC809 (FAS) - (06/04)
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