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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500301453
Report Date: 12/04/2024
Date Signed: 12/04/2024 03:52:43 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 12/04/2024 03:52 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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:COVENANT LIVING OF TURLOCKFACILITY NUMBER:
500301453
ADMINISTRATOR/
DIRECTOR:		RYAN HUSTFACILITY TYPE:
741
ADDRESS:2125 N OLIVE AVENUETELEPHONE:
(209) 632-9976
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY: 377TOTAL ENROLLED CHILDREN: 0CENSUS: 288DATE:
12/04/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Jiane Bassi, Associate Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 12/04/2024, Licensing Program Analyst (LPA) Renee Campbell arrived to the facility to conduct an annual inspection. LPA Campbell met with Jianne Bassi, Associate Executive Director and explained the purpose of the visit.

With the assistance of staff Kelsey Henderson, Employee Experience Leader and Carrie Rodriguez, Human Resources Assistant, LPA Campbell reviewed staff files. Of the 159 staff files, LPA Campbell reviewed 10 staff files that were found to be complete.

Due to insufficient time, the annual will require a continuation visit. The Department will return at a later date to complete the annual inspection.
Lisa RiosTELEPHONE: (916) 969-9685
Renee CampbellTELEPHONE: (916) 206-6380
DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
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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