<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107206884
Report Date: 04/21/2023
Date Signed: 04/21/2023 10:38:00 AM


Document Has Been Signed on 04/21/2023 10:38 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:ATTENTIVE SENIOR CARE, LLCFACILITY NUMBER:
107206884
ADMINISTRATOR:HOLLAND, LAWRENCEFACILITY TYPE:
740
ADDRESS:36 E. TUOLUMNE STREETTELEPHONE:
(559) 449-3566
CITY:FRESNOSTATE: CAZIP CODE:
93706
CAPACITY:6CENSUS: 6DATE:
04/21/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:43 AM
MET WITH:Administrator, Lawrence Holland Facility Staff, Stanisha Harris TIME COMPLETED:
11:04 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 04/21/2023, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct a POC visit. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. Administrator, Lawrence Holland is not present in the facility. Facility staff contacted Administrator via telephone. LPA received verbal permission to begin the inspection with Facility staff, Stanisha Harris. Administrator arrived a short time later.

On 03/24/2023, the facility was issued a deficiency for a violation of California Code of Regulation section 87303(a). During today's visit, LPA confirmed that the sink in bathroom 2 has been repaired. This deficiency will be cleared during today's visit.

On 03/24/2023, the facility was issued a deficiency for a violation of California Code of Regulation section 87303(e)(2). During today's visit, LPA measured hot water in bathroom 1 and bathroom 2. The hot water in bathroom 1 measured at 107.2 degrees F. The hot water in bathroom 2 measured at 107.6 degrees F. This deficiency will be cleared during today's visit.

No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to Administrator, Lawrence Holland, whose signature on this form confirms receipt of this document.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:
DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/21/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1