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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500301324
Report Date: 03/14/2023
Date Signed: 03/14/2023 12:40:07 PM


Document Has Been Signed on 03/14/2023 12:40 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-CC, 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: 58DATE:
03/14/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Sherry Gonzales TIME COMPLETED:
01:00 PM
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On 03/14/2023, Licensing Program Analysts (LPAs) Denisia Jimenez and Nancy Her met with Director Sherry Gonzales for an unannounced case management inspection. LPAs toured the facility and a census was taken. An Unusual Incident Report was submitted to the Fresno Community Care Licensing Office (CCL) regarding an incident that occurred on 02/23/2023 regarding personal rights.

LPAs gathered information and interviewed Director and staff members. Due to insufficient information at this time, the above incident will need further investigation.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, no deficiency was cited during today’s inspection.

Exit interview was conducted with facility representative Director Sherry Gonzales.

A Notice of Site Visit was given.
SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Denisia JimenezTELEPHONE: (559) 767-0718
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2023
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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