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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547206667
Report Date: 09/08/2023
Date Signed: 09/08/2023 10:35:54 AM

Document Has Been Signed on 09/08/2023 10:35 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:PEOPLE'S CARE BLISS CENTER VISALIAFACILITY NUMBER:
547206667
ADMINISTRATOR:NEWLIN, ASHLEYFACILITY TYPE:
775
ADDRESS:909 W MURRAY RDTELEPHONE:
(559) 746-5368
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 60CENSUS: 34DATE:
09/08/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Ashley Newlin, Administrator
Emily Carpenter, Back up Administrator		TIME COMPLETED:
10:45 AM
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On 9/8/23 at 8:55 AM, Licensing Program Analysts (LPAs) Malia Thao and Lisa Salazar arrived unannounced to conduct a case management - incident inspection. LPAs explained reason for inspection and met with Administrator (ADM) Ashley Newlin and Back up Administrator Emily Carpenter.

CCL received an incident report that occurred on 8/14/23 involving C1.

LPAs reviewed records and conducted interviews.

No deficiency cited during this inspection.

ADM was not able to finish the inspection. Exit interview conducted with Back up Administrator. A copy of this report was given to Back up Administrator, whose signature confirms receipt of this report.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Malia Thao
LICENSING EVALUATOR SIGNATURE: DATE: 09/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2023
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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