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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547207231
Report Date: 12/09/2024
Date Signed: 12/09/2024 10:28:14 AM

Document Has Been Signed on 12/09/2024 10:28 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
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:SCOTT'S YOUTH FACILITY IIIFACILITY NUMBER:
547207231
ADMINISTRATOR/
DIRECTOR:		ROBERT CARTERFACILITY TYPE:
733
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 6CENSUS: 0DATE:
12/09/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Robert CarterTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On December 9, 2024 Licensing Program Analysts (LPAs) Briana Placencia and Angelica Borja travelled to Scott's Youth Facility III located at 2531 Arciero Drive Tulare CA 93274, to conduct a 2nd Pre-licensing inspection. LPA’s were met at the facility by Licensee Robert Carter and Tiffany Carter.

1. Facility Grounds were clear from debris
2. Outdoor space observed.
3. Chemicals were locked upon inspection.
4. Locked and centrally stored medications will be locked in the Mental Health room.
5. Two First aid kits were purchased.
6. Adequate storage space observed.
7. The house has 5 bedrooms, three client rooms double occupancy, staff office and a mental health room, all located on one single level. Bedrooms are furnished with appropriate bedding and dresser storage space.
8. Adequate food was present.
9. Weekly mock menu observed.
10. Dining room observed. Table and chairs for the facility were observed during inspection.
11. Facility has three full restrooms, all are operable. Facility is to ensure water temperature is maintained between 105 and 120 degrees.
12. Licensee has a vehicle for use at the facility. Including insurance and registration.
13. Licensee already has a guardian account.


Fire clearance was completed on December 28, 2022.
SUPERVISORS NAME: Tamara Melikian
LICENSING EVALUATOR NAME: Briana Placencia
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2024
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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