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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157202422
Report Date: 02/20/2025
Date Signed: 02/20/2025 12:35:55 PM

Document Has Been Signed on 02/20/2025 12:35 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:MOUNTAIN VISTA SENIOR CAREFACILITY NUMBER:
157202422
ADMINISTRATOR/
DIRECTOR:		HUNT, DANIELFACILITY TYPE:
740
ADDRESS:20001 PIEDRA DRIVETELEPHONE:
(661) 822-3556
CITY:TEHACHAPISTATE: CAZIP CODE:
93561
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/20/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:50 AM
MET WITH:Angela Elstein, Licensee's daughterTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
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 On 02/20/25 Licensing Program Analyst (LPA) M. Yang arrived announced to conduct a Case Management
visit and met with Angela Elstein, Licensee’s daughter. The department received notification of facility closing. The purpose of this visit was to conduct a final walk through of the facility. Licensee has surrendered license. No staff and residents observed present.

LPA toured the facility inside and outside. All bedrooms and bathrooms were empty of personal belongings. There was no indication of persons living in the facility. Licensee provided LPA information of residents’’ relocation.

Forfeiture to be sent. The facility will be closed effective 02/20/25, pending Licensing Program Manager
approval. Exit interview conducted.
See MouaTELEPHONE: (559) -65-7912
Mai YangTELEPHONE: 559-772-7402
DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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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