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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 507004864
Report Date: 01/03/2024
Date Signed: 01/03/2024 02:07:14 PM

Document Has Been Signed on 01/03/2024 02:07 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: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: 20DATE:
01/03/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Program Manager Marisol MorenoTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Jason Lund arrived to the facility unannounced to conduct an annual/required visit. LPA Lund met with Program Manager Marisol Moreno and explained the reason for the visit.

LPA Lund and Program Manager Marisol Moreno 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. The outside part of the facility is maintained and in compliance.

LPA Lund reviewed three staff and five clients’ files and were in compliance.

No deficiencies were observed during the visit, exit interview conducted and report left.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2024
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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