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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 247201669
Report Date: 08/22/2023
Date Signed: 08/23/2023 11:25:24 PM


Document Has Been Signed on 08/23/2023 11:25 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:MISSION GARDENSFACILITY NUMBER:
247201669
ADMINISTRATOR:ELINA MOILANENFACILITY TYPE:
740
ADDRESS:1450 EAST 27TH STREETTELEPHONE:
(209) 384-3300
CITY:MERCEDSTATE: CAZIP CODE:
95340
CAPACITY:15CENSUS: 0DATE:
08/22/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:32 PM
MET WITH:TIME COMPLETED:
03:00 PM
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On 8/22/23 at 2:32 p.m. Licensing Program Analyst (LPA) B. Miranda arrived to the facility unannounced to conduct an annual inspection. Upon arrival LPA observed the facility to be closed and no one was available.
LPA had previously been in contact with James Nordam who had stated the facility was closed the and license was previously forfeited back in June 2023.

Amie Machini no longer has possession of the facility.

LPA did not observe anyone living in the facility, and facility appeared to be empty.


SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brianna MirandaTELEPHONE: 559-770-0254
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2023
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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