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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500301324
Report Date: 09/16/2019
Date Signed: 09/16/2019 10:24:50 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MONTE VISTA CHILDRENS CENTERFACILITY NUMBER:
500301324
ADMINISTRATOR:GONZALES, SHERRYFACILITY TYPE:
850
ADDRESS:1619 E MONTE VISTA AVENUETELEPHONE:
(209) 632-8477
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY:108CENSUS: 60DATE:
09/16/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Director - Sherry GonzalesTIME COMPLETED:
10:30 AM
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On this date, Licensing Program Analyst (LPA) Luisa Gavoutian conducted an unannounced case management inspection. LPA met with Director Sherry Gonzales, toured the facility, inside and outside, and took a census.

The purpose of today's inspection was to provide Licensee with an amended report of the deficiencies that were issued on the LIC 9099D on June 26, 2019. On that day, Licensee was cited two deficiencies, one of which was dismissed. An amended copy of that LIC 9099D was provided to Licensee today.

No deficiencies were observed during today's inspection.

Exit interview conducted with Director Sherry Gonzales.

LIC 9213 Notice of Site Visit to be posted for 30 days.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2019
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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