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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209727
Report Date: 10/08/2026
Date Signed: 10/08/2026 04:06:23 PM

Document Has Been Signed on 10/08/2026 04:06 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
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:VILLAGES AT WILLOWFACILITY NUMBER:
107209727
ADMINISTRATOR/
DIRECTOR:		SMITH, PHYLICIAFACILITY TYPE:
740
ADDRESS:825 S WILLOWTELEPHONE:
(559) 550-5454
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 30CENSUS: 11DATE:
10/08/2026
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Kiran ChehalTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analysts (LPA) Katie Brown and Melinda Medina arrived to conduct the Pre-Licensing Inspection. LPAs met with Administrator (AD) Kiran Chehal and Licensees. Certification Number 7037226740 - Expiration 04/17/2028.

This facility property consists of 6 individual homes. LPAs walked the grounds and toured each home with AD. The following was observed in each house: Required postings were hung in the entry ways, common areas were clean with flooring and furniture in good repair. LPAs observed required items in bathrooms which were clean with hot water measuring between 109-112 degrees. LPAs observed hygiene items, paper products, towels, extra bedding, and linens available for use. The kitchens were clean and contained cooking items and appliances functioning as required. Each home contains a fire extinguisher which was serviced by Valley Fire 3/23/26. First Aid kits were available for use, containing required items. Doors and walkways were unobstructed throughout each home, including entrances and exits. Each house exit has locking capability for safety. There are multiple shaded seated areas and designated smoking areas available for residents. Each resident has a pendent to use when assistance is needed. Pendent/Call Light monitor screens were only placed in houses 841 and 877.

The facility is surrounded by an security gate. The gate itself has 3 pedestrian gates that are unlocked from the “facility side” allowing individuals to exit the property at any time. These gates are locked from the “street side”. Outside the back of House 865 are 2 sheds which LPAs observed inside. The sheds are used for facility furniture and supply storage.

See 809C for continuation

Shawna Doucette
Katie Brown
DATE: 10/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: VILLAGES AT WILLOW
FACILITY NUMBER: 107209727
VISIT DATE: 10/08/2026
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Pre-Licensing - Page 2

-House 825 - Fire Clearance for 4 Ambulatory only, currently unoccupied
-House 835 - Fire Clearance for 6 Non-Ambulatory, 2 can be bedridden - Currently 2 residents
-House 841 - Fire Clearance for 6 Non-Ambulatory, 2 can be bedridden - Currently 3 residents
-House 853 - Fire Clearance for 4 Non-Ambulatory, 2 can be bedridden - Currently 2 residents
-House 865 - Fire Clearance for 4 Ambulatory only - Currently 2 residents
-House 877 - Fire Clearance for 6 Non-Ambulatory, 2 can be bedridden - Currently 2 residents
-House 881 is the Facility Office

During this inspection, LPAs reviewed staffing, resident call light system improvement and training requirements. Emergency Disaster and Infection Control Procedures were also reviewed with AD and Licensees.

The following requirements have not been met:
1. Trash Cans to be placed in each bedroom and bathroom
2. House 841- bathroom 1 - Drawers to be repaired or secured, toilet paper holder to be replaced/repaired and wall damage repaired, wall repair under window.
3. House 841- bedroom 1 - closet floor track to be removed, night stand drawer to be repaired.
bathroom 2 - under window towel bar to be removed or repaired


AD will contact LPA Brown when the above requirements have been resolved to schedule a subsequent visit.

An exit interview was conducted and a copy of this report was provided.






NAME OF LICENSING PROGRAM MANAGER: Shawna Doucette
NAME OF LICENSING PROGRAM ANALYST: Katie Brown
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2026
LIC809 (FAS) - (06/04)
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