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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100400622
Report Date: 07/31/2023
Date Signed: 07/31/2023 05:11:47 PM


Document Has Been Signed on 07/31/2023 05:11 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:TWILIGHT HAVENFACILITY NUMBER:
100400622
ADMINISTRATOR:LONG, TERESAFACILITY TYPE:
740
ADDRESS:1717 SOUTH WINERY AVENUETELEPHONE:
(559) 251-8417
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:116CENSUS: 30DATE:
07/31/2023
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
04:15 PM
MET WITH:RCFE Operations Manager (OM) Kristine WilliamsTIME COMPLETED:
05:15 PM
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An unannounced Case Management - Health & Safety visit was conducted on the date & time indicated by Licensing Program Analyst (LPA) K. McClurg. LPA met with RCFE Operations Manager (OM) Kristine Williams.

Facility toured. Facility appeared to be clean, safe, sanitary, & in good repair including: floors, ceilings, dining room, furnishings, facility grounds, etc. No unpleasant odors detected during walk-through. Walkways & exits clear without obstructions.

Facility has not experienced any interruption of services such as food, water, electrical, phone services, television, public utilities &/or services to date. Food deliveries continue to be received weekly.

According OM, the Bridge Loan continues to be in process with bank.

Exit interview conducted with OM. Copy of report provided.
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) 580-4596
LICENSING EVALUATOR NAME: Kelly J. McClurgTELEPHONE: (559) 246-0435
LICENSING EVALUATOR SIGNATURE:
DATE: 07/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/31/2023
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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