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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 247202427
Report Date: 08/09/2024
Date Signed: 08/12/2024 10:21:36 PM


Document Has Been Signed on 08/12/2024 10:21 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:TERRIE'S TLC SENIOR HOME IIFACILITY NUMBER:
247202427
ADMINISTRATOR:RHODES, THERESE ANNEFACILITY TYPE:
740
ADDRESS:1317 E BROOKDALE DR.TELEPHONE:
(209) 726-0548
CITY:MERCEDSTATE: CAZIP CODE:
95340
CAPACITY:6CENSUS: 0DATE:
08/09/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:TIME COMPLETED:
01:30 PM
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On 8/9/2024 Licensing Program Analyst (LPA) B. Miranda arrived to the facility unannounced to conduct a case management visit.

LPA previously received a letter from the Licensee Terrie Rhodes the facility was closing as of 7/8/2024. LPA called Licensee to see if they could met at the facility to show the house and verify there were no residents. Licensee stated the house is being rented and the two residents who were at the facility were moved to the Licensee's other facility.

LPA knocked on the door and explained who she was. LPA asked for Terrie was not there and was informed the house is being rented. LPA asked tenant when they moved in and the tenant stated last Saturday on 8/3/24. LPAs asked if there are any residents residing in the house, the women stated no.

LPA thanked the women and left.
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brianna MirandaTELEPHONE: 559-770-0254
LICENSING EVALUATOR SIGNATURE:
DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2024
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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