<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 275201364
Report Date: 02/04/2025
Date Signed: 02/04/2025 08:58:36 PM

Document Has Been Signed on 02/04/2025 08:58 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:MARINA HOUSE, THEFACILITY NUMBER:
275201364
ADMINISTRATOR/
DIRECTOR:		GRANT, DAWNFACILITY TYPE:
735
ADDRESS:3305 RIO ROADTELEPHONE:
(831) 622-9181
CITY:CARMELSTATE: CAZIP CODE:
93923
CAPACITY: 5CENSUS: 3DATE:
02/04/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:53 AM
MET WITH:Licensee Trevor GrantTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 02/04/2025, Licensing Program Analyst (LPA) V. Gorban conducted unannounced visit to conduct case management, health and safety checks visit on clients in care. LPA contacted Licensee due to no response to door bell, who arrived shortly. Licensee LPA introduced self and allowed entry in to the facility by Licensee Trevor Grant.

During this visit LPA toured the facility in side and out. During the visit all three clients were out, attending day program. LPA reviewed staffing schedule and other facility records and interviewed Licensee. Based on interview, facility closure date is April 30th, 2025 and Licensee currently working with regional center to proper placement and relocation of clients.

No deficiency was observed and cited during this visit. Exit interview conducted, report signed and copy of this report provided to Licensee for facility records.


SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE: DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/04/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1