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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209039
Report Date: 07/29/2020
Date Signed: 05/03/2022 08:52:45 AM


Document Has Been Signed on 05/03/2022 08:52 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
, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:APRICOT MORNINGS IVFACILITY NUMBER:
107209039
ADMINISTRATOR:HURLEY, JACK C.FACILITY TYPE:
740
ADDRESS:783 QUINCY AVETELEPHONE:
(559) 430-5743
CITY:CLOVISSTATE: CAZIP CODE:
93619
CAPACITY:6CENSUS: 0DATE:
07/29/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Jack HurleyTIME COMPLETED:
10:26 AM
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On or about today's date and due to the Covid-19, LPA, Les Xiong did a televisit inspection at the above facility for an announced Pre-licensing visit. LPA met with Administrator, Jack Hurley.

Administrator cell phone: 559-430-5743, email: jackhurley@yahoo.com.

LPA televisit was conducted for the above facility. Common rooms have adequate furnishings and lighting. All of the resident bedrooms have adequate lighting. Hot water temperature in bathrooms measured at 115 degrees. LPA observed a supply of extra bed linens and personal hygiene and grooming products. Kitchen observed to ready for food storage and preparation. Cleaning supplies and knives will be stored in a locking cabinets. Medications will be kept in a locked storage/medication cabinets. First aid kit contains all the required items. A fire extinguisher is present and up to date. Smoke detectors/carbon monoxide were present and functional.

Outside of the facility toured. No hazards were observed.

Component 3 orientation was conducted during this visit. All required postings are posted.

I have found that applicant has met all pre-licensing requirements. LPA will submit the application for further processing.
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Les XiongTELEPHONE: (559) 410-1772
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2020
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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