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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107206649
Report Date: 06/09/2022
Date Signed: 06/09/2022 10:55:19 AM


Document Has Been Signed on 06/09/2022 10:55 AM - 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:SUNRISE OF FRESNOFACILITY NUMBER:
107206649
ADMINISTRATOR:BREWER, NORSHELLFACILITY TYPE:
740
ADDRESS:7444 N. CEDARTELEPHONE:
(559) 325-8170
CITY:FRESNOSTATE: CAZIP CODE:
93720
CAPACITY:89CENSUS: 75DATE:
06/09/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:51 AM
MET WITH:Administrator, Norshell BrewerTIME COMPLETED:
11:07 AM
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On 06/09/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct a Case Management visit. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Norshell Brewer.

The purpose of today's visit is to follow up on incident reports submitted to the Fresno CCL office.

No deficiencies issued during today's visit.

Exit interview conducted. A copy of this report was discussed and provided to Administrator, Norshell Brewer, whose signature on this form confirms receiving this document.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:
DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2022
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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