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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107201663
Report Date: 09/08/2023
Date Signed: 09/08/2023 01:58:35 PM


Document Has Been Signed on 09/08/2023 01:58 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:SERENITY LIVINGFACILITY NUMBER:
107201663
ADMINISTRATOR:JONES, JOSIANEFACILITY TYPE:
740
ADDRESS:2605 W. BARSTOW AVENUETELEPHONE:
(559) 449-0504
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY:6CENSUS: 0DATE:
09/08/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:24 PM
MET WITH:Licensee, Josiane JonesTIME COMPLETED:
02:01 PM
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On 9/8/2023 an Office Meeting was completed with Licensee, Josiane Jones per Licensee request. Elaine Sauceda, identified as staff was present with Licensee. Meeting was held with attendees Regional Office Manager, Brenda White, Licensing Program Manager, See Moua and Licensing Program Analyst, Mary Garza present.

Notification from Licensee, of home being placed on the market as of 9/7/2023. Discussion of home closure with Licensee and direction of proper procedures were had.

During last visit LPA, M. Garza provided Licensee regulations on the closure process.

Licensee will notify CCL when decision has been made.

Exit interview completed with Licensee, Josiane. A copy of this report was given.
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -580-4596
LICENSING EVALUATOR NAME: Mary GarzaTELEPHONE: 559-365-9009
LICENSING EVALUATOR SIGNATURE:
DATE: 09/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/08/2023
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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