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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 507004751
Report Date: 04/12/2022
Date Signed: 04/12/2022 12:49:24 PM

Document Has Been Signed on 04/12/2022 12:49 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:TURNER RESIDENTIAL CAREFACILITY NUMBER:
507004751
ADMINISTRATOR:TURNER, WILL J.FACILITY TYPE:
735
ADDRESS:613 FLOYD AVENUETELEPHONE:
(209) 522-5600
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY: 12CENSUS: 10DATE:
04/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Administrator Will TurnerTIME COMPLETED:
01:00 PM
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LPA Jason Lund arrived at the facility unannounced to conduct an annual required inspection. LPA met with Administrators, Will Turner & Yolonda Turner. There are currently 10 residents who reside at this house.

LPA toured the facility with Administrator. LPA observed the interior and the exterior of the facility were inspected including the common living spaces, resident bedrooms and bathrooms, and kitchen. Bathrooms and bedrooms were clean and in good repair. There is a locked storage for medications and toxins. Food supply is adequate for 2-day perishable and 7-day nonperishable. Smoke alarms were checked and found in good working order. Carbon Monoxide detector was found in good working order. All residents are ambulatory. This facility is operating within the scope of their license.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

Exit interview conducted and copy of report provided.
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2022
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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