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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547206782
Report Date: 08/15/2024
Date Signed: 08/15/2024 01:32:39 PM

Document Has Been Signed on 08/15/2024 01:32 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
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:EMPLOY AMERICAFACILITY NUMBER:
547206782
ADMINISTRATOR/
DIRECTOR:
DANIELLE, BELTRANFACILITY TYPE:
775
ADDRESS:340 N. FOURTH STTELEPHONE:
(559) 443-7119
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 90CENSUS: DATE:
08/15/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:44 PM
MET WITH:Stephanie RamirezTIME VISIT/
INSPECTION COMPLETED:
01:50 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
LPA, L. Xiong was at the above facility for a collateral visit regarding complaint #24-AS-20240814093419. During the visit, interviews and records were conducted and obtained.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2024
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 1