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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100400622
Report Date: 05/03/2023
Date Signed: 05/03/2023 04:01:11 PM


Document Has Been Signed on 05/03/2023 04:01 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:TWILIGHT HAVENFACILITY NUMBER:
100400622
ADMINISTRATOR:RAMIREZ, SYLVIAFACILITY TYPE:
740
ADDRESS:1717 SOUTH WINERY AVENUETELEPHONE:
(559) 251-8417
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:116CENSUS: 32DATE:
05/03/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Kristine Williams, CEO and Teresa Long, AdministratorTIME COMPLETED:
04:00 PM
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A virtual office meeting was conducted on this date regarding the facility. Present from CCL were:

Assistant Program Administrator, Stacy Barlow
Regional Manager, Brenda White,
Audit Manager, Jacqueline Juarez
Licensing Program Manager(s), See Moua and Sergiy Pidgirny
Licensing Program Analyst, Mai Yang

From the Facility:
CEO, Kristine Williams
Administrator, Teresa Long

The purpose of the meeting was to discuss the facility’s operation and its finances. Audit Manager discussed finances with Administrator and CEO.

Concerns – one factor affecting the facility’s ability to make payroll is facility’s insurance. Facility will provide update regarding insurance information as soon as possible.

Requested information – Current Budget, new LIC 401 to include Independent Living

Outcome – recommend financial monitoring should the facility continue operation.

Information regarding capacity change was also provided to the facility.
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -65-7912
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023
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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