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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 540408972
Report Date: 02/03/2025
Date Signed: 02/05/2025 09:35:56 AM

Document Has Been Signed on 02/05/2025 09:35 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
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:PORTERVILLE SHELTERED WORKSHOPFACILITY NUMBER:
540408972
ADMINISTRATOR/
DIRECTOR:		MARSHA SHOEMAKEFACILITY TYPE:
775
ADDRESS:621 SOUTH E STREETTELEPHONE:
(559) 784-1399
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 270CENSUS: 88DATE:
02/03/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:12 PM
MET WITH:Valarie MasonTIME VISIT/
INSPECTION COMPLETED:
02:58 PM
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Today, Licensing Program Analyst L. Xiong arrived at the facility unannounced to conduct an Annual inspection. LPA met Program Coordinator Valerie Mason and inform her the purpose of the visit.

LPA toured the facility with staff. Facility appeared clean with no obstruction or fire clearance issues. All common areas have adequate seating and lighting. Resident bedrooms toured, rooms observed to have all required accommodations.

Smoke detector and carbon monoxide detectors observed operational during inspection. Fire extinguisher present with a service date of 06/2024. Water temperature observed to measure at 105 degrees F.

No deficiencies were observed.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE: DATE: 02/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2025
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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