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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107204214
Report Date: 12/09/2021
Date Signed: 12/10/2021 01:48:24 PM

Document Has Been Signed on 12/10/2021 01:48 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:UCP OF CENTRAL CALIFORNIA-CHEERSFACILITY NUMBER:
107204214
ADMINISTRATOR:CUNNINGHAM, KELLYFACILITY TYPE:
775
ADDRESS:157 E. GLENN AVE.TELEPHONE:
(559) 934-1126
CITY:COALINGASTATE: CAZIP CODE:
93210
CAPACITY: 45CENSUS: 0DATE:
12/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Elizabeth Lodal - InstructorTIME COMPLETED:
02:00 PM
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Licensing Program Analyst(LPA) D. Ayers arrived at the facility unannounced to conduct a required annual inspection. LPA met with Instructor Elizabeth Lodal. LPA announced the purpose of the visit.

LPA conducted a tour of the facility. All passageways and exits were clear and free from obstruction. All fire extinguishers had been recently serviced. The facility has an integrated sprinkler system. The last fire drill was conducted 11/22/2021. All bathrooms were clean and odor free. All faucets and fixtures were functioning properly.

LPA observed the facility kitchen area to be clean and all fixtures were operational. LPA reviewed facility disaster plan. The facility has four vehicles for transporting clients, all of which are regularly maintained and have fire extinguishers and first aid kits. No deficiencies cited during the inspection. A copy of the report was provided to the licensee via email.
SUPERVISORS NAME: Andy Xiong
LICENSING EVALUATOR NAME: David Ayers
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2021
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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