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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547208802
Report Date: 09/21/2021
Date Signed: 09/21/2021 01:27:38 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:OPEN ARMS HOUSE, THEFACILITY NUMBER:
547208802
ADMINISTRATOR:JIMENEZ, SABRINAFACILITY TYPE:
740
ADDRESS:3234 W IRIS AVETELEPHONE:
(559) 713-6542
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY:6CENSUS: 0DATE:
09/21/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Administrator, Sabrina Jimenez via telephoneTIME COMPLETED:
09:10 AM
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On 09/21/2021, Licensing Program Analysts (LPAs) M.Yang and S. Doucette arrived unannounced and attempted to conduct an Infection Control Annual Inspection. LPAs knocked on the door and contacted Administrator, Sabrina Jimenez via telephone and spoke with Administrator Sabrina Jimenez. Administrator states unable to attend this meeting. The facility currently has no residents and there are no staff present. Administrator states facility will be in process of closure effective 09/30/21. Administrator was advise to provide a letter of closure effective date to licensing. LPAs will return at a later date to conduct the Annual Inspection/ Closure. A copy of report submitted via email to administrator.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 243-8080
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021
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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