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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 01:39:54 PM

Document Has Been Signed on 02/24/2025 01:39 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:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Constance PetersTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 2/24/25, Licensing Program Analysts (LPAs) Daiquiri Boyd and Rachel Bruce made an unannounced visit to the facility to conduct an Annual Inspection and were met by Administrator (AD) Constance Peters.

LPAs Boyd and Bruce toured the three facility buildings with AD. Documentation of the facility tour was done by LPA Bruce on separate LIC809 with the same date.

This form has the file review for staff and clients attached.
Sergiy PidgirnyTELEPHONE: (559) 243-8080
Daiquiri BoydTELEPHONE: 559-243-8080
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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