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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206908
Report Date: 06/13/2022
Date Signed: 06/20/2022 03:20:50 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 06/20/2022 03:20 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:LIFE SKILLS AND VOCATIONAL CENTERFACILITY NUMBER:
157206908
ADMINISTRATOR:BOLANOS,M.& MACHADO, JOSEFACILITY TYPE:
775
ADDRESS:1414 GARCES HIGHWAYTELEPHONE:
(661) 721-3220
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY: 50CENSUS: 15DATE:
06/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:06 AM
MET WITH:Program Administrator, Jose MachadoTIME COMPLETED:
12:30 PM
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On 06/13/22, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to conduct an Annual Inspection - Infection Control. LPA met Program Administrator. LPA stated the purpose of the visit, was allowed entry and completed a tour of the facility. 15 clients were present during the inspection.

Visitor log-in/temperature check was observed upon entry. Hand sanitizer was readily available to clients and visitors. A 30-day PPE supply is stored in the back storage and the main office. Client restrooms were tour, observed to be free from debris, and operational. LPA observed hand washing posting by all sinks. Social distancing is maintained in the common areas. LPA observed social distancing and cough etiquette postings in facility.

The Day Program has separate classrooms for activities as well as an activities . Facility is maintained at a temperature of 73 degrees F. No passageway obstructions or fire hazards were observed inside or outside. Fire extinguishers were observed with an expiration date of 04/20/2022.

Client files have updated emergency contact information and staff files have current 1st Aid and CPR training.

No deficiency observed.

Exit Interview conducted. The following documents are requested and to be submitted to Fresno CCL by: 06/30/22. The following updated forms were requested: LIC308, LIC309 (if applicable), LIC500, LIC 610D, LIC9020, and updated Administrator certificate. A copy of this report was provided to Program Administrator.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE: DATE: 06/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2022
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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