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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 247209073
Report Date: 01/04/2024
Date Signed: 01/16/2024 04:38:04 PM


Document Has Been Signed on 01/16/2024 04:38 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:MARIA LOVING CAREFACILITY NUMBER:
247209073
ADMINISTRATOR:PELAYO, CHRISTINA MFACILITY TYPE:
740
ADDRESS:1115 PAYNE AVENUETELEPHONE:
(209) 733-8136
CITY:GUSTINESTATE: CAZIP CODE:
95322
CAPACITY:6CENSUS: 0DATE:
01/04/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Licensee Maria DrumondeTIME COMPLETED:
11:00 AM
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On 1/4/24 at 10:30 a.m. Licensing Program Analyst (LPA) B. Miranda arrived to the facility unannounced to conduct a final walk through of the facility. Facility reported it closed as of 12/1/23. LPA met with Licensee Maria Drumonde.

Facility currently has no residents. The last resident had previously given their 30-day notice and left the facility as of 11/30/23. Facility no longer has sign outside advertising the facility.

LPA conducted a tour of the facility. LPA did not find any residents to be residing in the facility or items belonging to residents. Licensee will mail the facility license to the office by 1/8/23.

An exit interview was conducted, and a copy of this report was provided to Licensee Maria.

SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brianna MirandaTELEPHONE: 559-770-0254
LICENSING EVALUATOR SIGNATURE:
DATE: 01/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/04/2024
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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