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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107208829
Report Date: 02/21/2023
Date Signed: 02/21/2023 11:14:59 AM

Document Has Been Signed on 02/21/2023 11:14 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:PARADISE COMMUNITY CARE HOMES INCFACILITY NUMBER:
107208829
ADMINISTRATOR:ZEPEDA, RIGOBERTOFACILITY TYPE:
735
ADDRESS:2412 S. PLAYA AVETELEPHONE:
(559) 412-7875
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 4CENSUS: 2DATE:
02/21/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:02 AM
MET WITH:Administrator Rigoberto Zepeda via telephoneTIME COMPLETED:
11:15 AM
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On 02/21/23 at approximately 11:02AM, Licensing Program Analysts (LPA) M. Yang arrived unannounced for a case management - other inspection regarding immediate exclusion of Staff 1 (S1). LPA knocked on the door. There was no answer. LPA who called Administrator Rigoberto Zepeda via telepohone. Administrator stated unable to attend meeting. LPA discuss S1 with Administrator via telephone.

LPA was informed by Administrator that excluded Staff member is no longer working at the facility.
Staff is no longer employed at the facility. Staff is not associate with facility.

No deficiency was observed.

Exit Interview was conducted. Report was provided to Administrator via email. Signature on file.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2023
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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