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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209310
Report Date: 06/16/2023
Date Signed: 06/16/2023 10:19:29 AM

Document Has Been Signed on 06/16/2023 10:19 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:AMFC DAY PROGRAM INCFACILITY NUMBER:
157209310
ADMINISTRATOR:ALLISON-MORGAN, TORIFACILITY TYPE:
775
ADDRESS:7825 CALIFORNIA BLVDTELEPHONE:
(661) 717-7628
CITY:CALIFORNIA CITYSTATE: CAZIP CODE:
93505
CAPACITY: 20CENSUS: 0DATE:
06/16/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Program Director Tori Allison-MorganTIME COMPLETED:
10:45 AM
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Licensing Program Analysts (LPA)'s Shawna Doucette and Brianna Miranda conducted an announced Pre-Licensing visit. LPA's met with Program Director Tori Allison-Morgan.

LPA's toured the facility. Facility license will include Suite A as the administration office, and Suite B, C and D will be operational for clients. Suite A, B and C are connected. Suite D is a separate room and is accessible to enter from the outside.

The temperature of the facility is set at 74 F. Facility has cleaning supplies in a locked tub. Medications will be locked in a lock box. There was seating and tables for clients in each room. Suite D is set up as a theater room with seating only. Water temperature in bathroom is measured at 118.9 F. All bathrooms have grab bars. Facility has appropriate lighting. Facility has cameras in common areas.

There is no kitchen on the premises. Facility will not be serving meals.

Facility has four fire extinguishers, one in each suite. Carbon monoxide and smoke detectors are operational.
Facility needs Ombudsman and Community Care Licensing Let Us Know posters.

There are 4 locked garages on the property which will not be licensed and landlord has not provided access to those garages.

An exit interview was conducted with Program Director Tori Allison-Morgan and a copy of this report was provided.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2023
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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