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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500301453
Report Date: 12/01/2022
Date Signed: 12/01/2022 02:50:53 PM


Document Has Been Signed on 12/01/2022 02:50 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:COVENANT LIVING OF TURLOCKFACILITY NUMBER:
500301453
ADMINISTRATOR:RYAN HUSTFACILITY TYPE:
741
ADDRESS:2125 N OLIVE AVENUETELEPHONE:
(209) 632-9976
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY:377CENSUS: 273DATE:
12/01/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Executive Director Ryan Hust TIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Jason Lund made an unannounced visit to conduct an annual/required inspection. LPA were met by Executive Director Ryan Hust and explained the reason for the visit.

LPA' Lund & Executive Director Ryan Hust toured/inspected all seven buildings which included buildings Sequoia, the assisted living building, Aspen, Birch, and Redwood. The interior of every building was found to be neat, clean, organized and well furnished. The exterior grounds were well landscaped and maintained in excellent condition.

The kitchen was inspected with the assistance of Director Leona Duvall. The large freezers were inspected in were found to be in a neat and organized condition. The kitchen had the required 7- days non-perishable and 2- day perishable food supplies.

Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no violations were observed during the annual required visit only.

Exit interview held, copy of report given to Executive Director Ryan Hust
SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason LundTELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2022
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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