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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107206664
Report Date: 11/08/2023
Date Signed: 11/08/2023 11:56:50 AM

Document Has Been Signed on 11/08/2023 11:56 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:BURRUS ADULT RESIDENTIALFACILITY NUMBER:
107206664
ADMINISTRATOR:BURRUS, LINDAFACILITY TYPE:
735
ADDRESS:157 N. ARMSTRONGTELEPHONE:
(559) 321-8737
CITY:CLOVISSTATE: CAZIP CODE:
93611
CAPACITY: 6CENSUS: 4DATE:
11/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Linda BurrusTIME COMPLETED:
11:25 AM
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On 11/08/23, Licensing Program Analyst (LPA) M. Medina made an unannounced Annual Required inspection and was allowed entrance into facility by Licensee, Linda Burrus. LPA met with Licensee/Administrator, Linda Burrus Certificate #6020323725, expires 11/30/2024.

Currently 4 residents in care. All residents were present at start of inspection. Residents attend day program Monday through Friday 8:00 AM - 2:00 PM.

Facility tour conducted both inside and outside. Residents bedrooms have all required accommodations. Living room and dining room areas have adequate seating and lighting for all residents. Kitchen tour conducted, LPA observed a 7-day non-perishable and 2-day perishable supply of food available. Medications observed to be locked and secured in facility office. Fire extinguisher last serviced 12/19/22, smoke detectors and carbon monoxide detectors observed operational during today's inspection. According to facility records, the most recent fire drill was conducted on 07/05/23.

Outside tour of facility conducted. All fire exits open freely and are free of obstruction. No hazards observed.

LPA conducted interviews and reviewed staff and resident files during inspection.

No deficiencies cited during today's inspection.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2023
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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