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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547201719
Report Date: 01/25/2023
Date Signed: 01/25/2023 09:37:41 AM


Document Has Been Signed on 01/25/2023 09:37 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:TWIN OAKS ASSISTED LIVING CENTERFACILITY NUMBER:
547201719
ADMINISTRATOR:MANDY RANCOURFACILITY TYPE:
740
ADDRESS:999 NORTH M STREETTELEPHONE:
(559) 684-1001
CITY:TULARESTATE: CAZIP CODE:
93274
CAPACITY:85CENSUS: 62DATE:
01/25/2023
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Mandy Rancour, AdministratorTIME COMPLETED:
09:50 AM
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On 1/25/23 at 8:45 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a collateral inspection for complaint inspection #24-AS-20221114142745. LPA explained reason for inspection and was granted entry by Administrator (ADM) Mandy Rancour.

LPA conducted interviews with R1 and ADM.

Exit interview conducted. A copy of this report was given to Mandy Rancour, whose signature confirms receipt of this report.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) -341-3274
LICENSING EVALUATOR NAME: Malia ThaoTELEPHONE: 559-470-9001
LICENSING EVALUATOR SIGNATURE:
DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/25/2023
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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