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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547201564
Report Date: 09/26/2023
Date Signed: 09/27/2023 06:47:38 PM


Document Has Been Signed on 09/27/2023 06:47 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:LOVING CARE ASSISTED LIVINGFACILITY NUMBER:
547201564
ADMINISTRATOR:PERRY, FEFACILITY TYPE:
740
ADDRESS:1542 E. GLENWOOD AVENUETELEPHONE:
(559) 688-4835
CITY:TULARESTATE: CAZIP CODE:
93274
CAPACITY:6CENSUS: 3DATE:
09/26/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:59 AM
MET WITH:Armando Cervantes, Acting Administrator TIME COMPLETED:
02:55 PM
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On 09/26/23, Licensing Program Analyst (LPA) L. Salazar arrived at the facility unannounced to conduct the required annual inspection. LPA met with Acting Administrator, Armando Cervantes, stated the purpose of the visit and was allowed entry into the facility.

LPA observed 3 resident's in care at the time of visit. There are no residents with Dementia or Restricted Health conditions. LPA did not observe any Health & Safety concerns during the visit.

The facility is currently under a change of ownership at this time. LPA toured the facility inside and out, discussed regulations, required postings, and training requirements for the Pre-licensing inspection that will be scheduled within four weeks. LPA will complete full inspection at the scheduled Pre-Licensing visit.

No deficiencies cited on today's visit. A copy of this report was provided at the time of visit.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Lisa SalazarTELEPHONE: (559) 691-0004
LICENSING EVALUATOR SIGNATURE:
DATE: 09/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2023
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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