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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503602075
Report Date: 07/11/2019
Date Signed: 07/11/2019 12:47:52 PM

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:CCCDS TURLOCK CHILD DEVELOPMENT CENTERFACILITY NUMBER:
503602075
ADMINISTRATOR:FELIX, CALLETANAFACILITY TYPE:
830
ADDRESS:400 NORTH KILROY RDTELEPHONE:
(209) 669-6374
CITY:TURLOCKSTATE: CAZIP CODE:
95380
CAPACITY:36CENSUS: 19DATE:
07/11/2019
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Director - Calletana FelixTIME COMPLETED:
01:00 PM
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On this date, Licensing Program Analyst (LPA) Luisa Gavoutian conducted an unannounced case management - annual continuation inspection. LPA met with Director Calletana Felix and took a census.

The purpose of today's case management inspection was to review staff records and conclude the annual/random inspection that was conducted on Tuesday, July 9, 2019. LPA reviewed staff records for all staff that were present at the facility during the annual/random inspection. LPA observed all staff files to be complete and orderly.

LPA discussed with Director an outstanding $50.00 balance that was due on October 1, 2018 for a capacity change. LPA provided a print out of information regarding the details of the fee to Director. Director stated that the main CCCDS office handles all licensing fees and will forward the information to get the balance resolved.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today. Exit interview was conducted with Director Calletana Felix.

This report is to be made available to the public upon request.

Site Visit Notice posted on the parent board.

SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019
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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