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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547206667
Report Date: 03/21/2023
Date Signed: 03/21/2023 01:56:12 PM

Document Has Been Signed on 03/21/2023 01:56 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:PEOPLE'S CARE BLISS CENTER VISALIAFACILITY NUMBER:
547206667
ADMINISTRATOR:DURAN, MELISSAFACILITY TYPE:
775
ADDRESS:909 W MURRAY RDTELEPHONE:
(559) 746-5368
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 60CENSUS: 30DATE:
03/21/2023
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Ashley Newlin, AdministratorTIME COMPLETED:
02:15 PM
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On 3/21/23 at 1:20 PM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a collateral inspection. LPA explained reason for inspection and was granted entry. LPA met with Administrator Ashley Newlin.

LPA interviewed client (C1).

No deficiencies cited during this inspection.

Exit interview conducted. A copy of this report was given to Administrator Ashley Newlin, whose signature confirms receipt of this report.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Malia Thao
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2023
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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