<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547204156
Report Date: 07/13/2023
Date Signed: 07/13/2023 11:58:19 AM

Document Has Been Signed on 07/13/2023 11:58 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, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:LINDSAY SERVICE CENTERFACILITY NUMBER:
547204156
ADMINISTRATOR:ESMERALDA GAITHERFACILITY TYPE:
775
ADDRESS:911 PARKSIDE AVENUETELEPHONE:
(559) 562-2713
CITY:LINDSAYSTATE: CAZIP CODE:
93247
CAPACITY: 45CENSUS: 9DATE:
07/13/2023
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Client Program Coordinator, Bethany Shoemake.
TIME COMPLETED:
12:09 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 07/13/2023, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an annual continuation inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA spoke with Administrator, Esmeralda Gaither via telephone. LPA met with Client Program Coordinator, Bethany Shoemake.

During today's visit, LPA reviewed records and measured the facility hot water. Hot water measured at 111.8 degrees F.

LPA amended a report created on 06/28/2023.

No deficiencies issued during today's inspection.

Exit interview conducted. A copy of this report was discussed and provided to Client Program Coordinator, Bethany Shoemake, whose signature on this form confirms receipt of this document.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5