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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 277209280
Report Date: 05/15/2024
Date Signed: 08/12/2024 10:39:24 AM

Document Has Been Signed on 08/12/2024 10:39 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:CRESCENT HOUSE, THEFACILITY NUMBER:
277209280
ADMINISTRATOR/
DIRECTOR:		SCHOPP, MICHELLEFACILITY TYPE:
735
ADDRESS:3017 CRESCENT STTELEPHONE:
(831) 601-8474
CITY:MARINASTATE: CAZIP CODE:
93933
CAPACITY: 6CENSUS: 0DATE:
05/15/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:52 PM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
01:19 PM
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On 5/4/2024 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to conduct an unannounced annual inspection. No one was available at the facility and LPA observed facility to not be occupied at this time. LPA attempted to contact Administrator with the phone number listed in the system. Phone call went to voicemail and LPA left voicemail for Administrator to return phone call.

LPA will attempt unannounced annual inspection at a later date.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2024
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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