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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 507004864
Report Date: 01/23/2023
Date Signed: 02/09/2023 10:34:08 PM

Document Has Been Signed on 02/09/2023 10:34 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:UNITED CEREBRAL PALSY ASSOC., INC. OF STAN. COUNTYFACILITY NUMBER:
507004864
ADMINISTRATOR:MORENO, MARISOLFACILITY TYPE:
775
ADDRESS:959 E. MONTE VISTA AVE, BLD 1TELEPHONE:
(209) 577-2122
CITY:TURLOCKSTATE: CAZIP CODE:
95381
CAPACITY: 60CENSUS: 15DATE:
01/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Team Leader Edith Alocer GarivayTIME COMPLETED:
12:45 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
Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct a annual/required inspection. LPA Lund met with Team Leader Edith Alocer Garivay and explained the reason for the visit.

LPA Lund and Team Leader Edith Alocer Garivay toured/inspected the facility. There is a large activity room and a computer lab room. LPA observed all rooms to be properly furnished, lighted and with no hazards present. There four client restrooms which were in sanitary condition, properly maintained. The kitchen was inspected with no hazards present. The facility's two changing rooms were organized and had a privacy system in place.

Upon inspection, all cleaning products and other toxins were locked away and inaccessible to residents. Smoke detectors are hard wired and maintained regularly by the property management company. The facility has a carbon monoxide detector. Fire extinguishers and first aid kits are maintained and ready for emergency use.


As a result of this visit, no deficiencies were observed. Exit interview conducted and copy of report left.
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2023
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