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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107206900
Report Date: 10/28/2021
Date Signed: 10/28/2021 02:16:21 PM

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:RATANAKONE HOMEFACILITY NUMBER:
107206900
ADMINISTRATOR:RATANAKONE, KEVINFACILITY TYPE:
740
ADDRESS:2220 N. PROSPECTTELEPHONE:
(559) 287-6366
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY:6CENSUS: 4DATE:
10/28/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Administrator, Dean MurphyTIME COMPLETED:
02:22 PM
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LPA arrived at the facility unannounced to conduct a Case Management inspection. LPA met with Administrator Kevin Ratanakone, AKA Dean Murphy.

The purpose of the visit is to assess Civil Penalties for failure to meet Plan of Correction due date.







A copy of this report and LIC421FC provided and exit interview conducted with the Administrator.


SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 650-7923
LICENSING EVALUATOR NAME: Katie BrownTELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
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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