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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107208838
Report Date: 02/24/2025
Date Signed: 02/24/2025 01:37:49 PM

Document Has Been Signed on 02/24/2025 01:37 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:MAGNOLIA CROSSINGFACILITY NUMBER:
107208838
ADMINISTRATOR/
DIRECTOR:
PETERS, CONSTANCEFACILITY TYPE:
740
ADDRESS:32 W SIERRA AVETELEPHONE:
(559) 765-4916
CITY:CLOVISSTATE: CAZIP CODE:
93612
CAPACITY: 60TOTAL ENROLLED CHILDREN: 0CENSUS: 42DATE:
02/24/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Constance Peters, Administrator TIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 02/24/2025, Licensing Program Analysts (LPAs). R Bruce and D Boyd arrived unannounced to conduct a required annual inspection. LPAs were allowed entrance, announced purpose of the visit and met with Administrator, Constance Peters.

LPAs toured the facility inside and out. LPAs checked water temperatures in three resident’s bathrooms which read between 107.6 and 114.5-degrees F. LPAs observed two fire extinguishers in each home (Poppy, Iris and Sage) and were last serviced by Jorgenson on 03/14/2024. Three kitchens were toured, adequate supply of food observed, and food stored properly for perishable and nonperishable. Medication for Poppy and Iris homes are locked next to the kitchen area in Iris home. Medication for Sage home is locked and located at the back end of the home. LPAs toured bedrooms in each home and all were found to be properly furnished with adequate lighting, appropriate furniture and storage space. Smoke detectors and carbon monoxide were last inspected by the Fire Marshall on 6/19/2024 and found to be in working order.

LPAs completed record reviews for staff and resident files. Completed on the Annual Continutation form saved on the same date. All required documentation was updated and in place, meeting regulatory requirements.


No deficiencies are being cited in accordance with the California Code of Regulations, Title 22, at today's inspection.

The following updated forms are to be submitted to CCL by 03/15/2025: LIC308, LIC 309, LIC 400, LIC 402, LIC 500, LIC 610D, LIC 9282, LIC999, and control of property.

An exit interview was conducted with the Administrator. A copy of this report was discussed with Administrator, Constance Peters whose signature on this form confirms receipt of this documents.

Sergiy PidgirnyTELEPHONE: (559) 246-0610
Rachel A BruceTELEPHONE: (559) 470-9001
DATE: 02/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2025
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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