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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 507005673
Report Date: 06/02/2023
Date Signed: 08/04/2023 09:28:08 AM


Document Has Been Signed on 08/04/2023 09:28 AM - 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:TRINITY VALLEY CAREFACILITY NUMBER:
507005673
ADMINISTRATOR:TRINIDAD, JOANNEFACILITY TYPE:
740
ADDRESS:242 S LAUREL STTELEPHONE:
(209) 678-4489
CITY:TURLOCKSTATE: CAZIP CODE:
95380
CAPACITY:15CENSUS: 7DATE:
06/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Administrator Joanne TrinidadTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct an annual/required inspection, LPA Lund met with Administrator Joanne Trinidad and explained the reason for the visit. Census 7

LPA Lund & manager Jason Trinidad toured/inspected the interior and the exterior of the facility. A tour of the common living spaces, resident bedrooms and bathrooms were conducted. In addition, a tour of the activity rooms, medication storage, and kitchen are was conducted. A tour of the garage and outdoor areas was conducted. Resident bedrooms were observed to be clean and in good repair at this time. There was a locked storage for medications which was observed to be inaccessible to the residents at this time. Food supply was adequate for 2-day perishable and 7-day nonperishable quantities.

Fire extinguishers were set to expire on 10/06/2023 and observed to be in compliance at this time. Smoke alarms are operational. This facility home had a carbon monoxide detector and observed to in compliance at this time. First Aid kit was on site and did contain all required components. Toxins were observed to be locked and made inaccessible to the residents at this time.

No deficiencies were observed during today’s visit.
Exit interview conducted with Administrator Joanne Trinidad and copy left.
SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason LundTELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:
DATE: 06/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/02/2023
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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