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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100400622
Report Date: 07/21/2023
Date Signed: 07/31/2023 04:56:09 PM


Document Has Been Signed on 07/31/2023 04:56 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: 32DATE:
07/21/2023
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:RCFE Operations Manager (OM) Kristine WilliamsTIME COMPLETED:
06:00 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. LPA introduced self & stated purpose of visit.

Facility tour conducted. Facility appeared to be clean, safe, sanitary, & good repair as observed including, but not limited to: floors, ceilings, dining room, furnishings, facility grounds, etc. No miscellaneous debris observed throughout facility. No unpleasant odors detected during walk-through. Food supplies appear to be sufficient. 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 move forward with the bank. Board has met & agreed to sale of property. Copy of Board Resolution has been provided to bank. Copy of Resolution provided & received by LPA @ time of visit.

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: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2023
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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