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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547206604
Report Date: 08/04/2021
Date Signed: 10/12/2021 03:35:53 PM

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:MAGNOLIA PARK ASSISTED LIVINGFACILITY NUMBER:
547206604
ADMINISTRATOR:GONZALEZ, ARNULFOFACILITY TYPE:
740
ADDRESS:2950 E. DOUGLAS AVE.TELEPHONE:
(559) 625-6001
CITY:VISALIASTATE: CAZIP CODE:
93292
CAPACITY:59CENSUS: 19DATE:
08/04/2021
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Esperanza Hansen, Administrator
Justin D. Harris, Attorney 		TIME COMPLETED:
03:15 PM
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Administrator Esperanza Hansen initiated an Office Meeting on this date to discuss the court hearing on 8/3/21 regarding the facility and ABLP, et al. and the Unlawful Detainer filed against the facility.

Present during the meeting:
Esperanza Hansen, Administrator
Justin D Harris, Attorney (by phone)
Brenda White, RM
Sergiy Pidgirny, LPM
See Moua

Outcome
-Motion of Stay for the Unlawful Detainer
-Licensee is still in control of the facility
-Licensee's lawsuit/court trial for Title/Control dispute is scheduled for 11/29/21 (CCL will be notified of any changes)
-No financial issue: facility is current on utilities, electricity, and water

Requested
Court Documents/Transcript for Motion of Stay
Updated Contingency Plan

Facility has no staffing and PPE supplies concerns.
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: See MouaTELEPHONE: (559) 650-7904
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021
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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