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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 150406808
Report Date: 06/18/2024
Date Signed: 06/18/2024 11:55:33 AM

Document Has Been Signed on 06/18/2024 11:55 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:DAI BREAKFACILITY NUMBER:
150406808
ADMINISTRATOR/
DIRECTOR:		CORNELL, BEVERLYFACILITY TYPE:
775
ADDRESS:14150 1/2 SUNSET BLVD.TELEPHONE:
(661) 854-4543
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY: 40CENSUS: 35DATE:
06/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Beverly Cornell
Christine Williams		TIME VISIT/
INSPECTION COMPLETED:
12:20 PM
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On 6/18/2024, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Inspection. LPA introduced self, stated purpose of visit, and allowed entrance. Facility tour conducted with Beverly Cornell, Administrator and Christine Williams, Chief Financial Officer.

Day Program currently operates Monday through Friday 7:15 AM - 3:15 PM. There are currently 36 clients enrolled and 35 clients present.

Day Program toured inside and outside. Clients observed to be in individual small groups in classroom and interacting in an educational setting with staff. Client bathrooms toured, fixtures observed to be operational during inspection. Water temperature measured at 113 degrees F.

No meals are prepared on site, all clients bring lunch from home. Refrigerators and microwaves are available in each classroom for lunches and heat meals as necessary. No medications are administered on site.

Fire extinguishers present on site and observed to have a service date of 10/26/23. Last fire drill conducted on 6/12/24 according to facility records.

No hazards observed on facility grounds.

Exit interview conducted. No deficiencies cited.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 06/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2024
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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