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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 540408972
Report Date: 03/14/2022
Date Signed: 03/14/2022 12:17:52 PM

Document Has Been Signed on 03/14/2022 12:17 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, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:PORTERVILLE SHELTERED WORKSHOPFACILITY NUMBER:
540408972
ADMINISTRATOR:MARSHA SHOEMAKEFACILITY TYPE:
775
ADDRESS:621 SOUTH E STREETTELEPHONE:
(559) 784-1399
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 270CENSUS: 35DATE:
03/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Marsha ShoemakeTIME COMPLETED:
12:20 PM
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Licensing Program Analyst (LPA) M. Medina arrived unannounced to conduct an Annual Inspection - Infection Control. LPA met with Program Supervisor, Marsha Shoemake and stated the purpose of the visit. LPA observed visitor log-in/temperature check. Facility staff observed to be wearing facial coverings.

All entrances, exits, and pathways were free from obstructions. No fire clearance issues observed during today's inspection. LPA observed signs at the entrance promoting social distancing, cough/sneeze etiquette, and hand-washing. Day Program clients observed to be in small cohorts, wearing masks and practicing social distancing. LPA observed reminders to wash hands in client bathrooms. Bathrooms were stocked with paper towels and liquid soap. Bathrooms observed to have lids on trash cans.

Day Program does not prepare meals on site, all clients bring lunch daily. Facility is sanitized throughout the day, and at conclusion of day. All clients emergency contact information has been updated.

Facility is equipped with a pull station, and both visual and auditory alarms. Fire extinguishers present with a service of 6/11/2021.

No deficiencies observed during this inspection.

Exit interview conducted with Program Supervisor. Facility report signed on site, as a COVID-19 precautionary measure, a copy of this report will be provided via email.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2022
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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