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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547208843
Report Date: 01/31/2024
Date Signed: 01/31/2024 07:40:48 PM

Document Has Been Signed on 01/31/2024 07:40 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:SOCIAL VOCATIONAL SERVICES, INCFACILITY NUMBER:
547208843
ADMINISTRATOR:REYNOSO, DAWNFACILITY TYPE:
775
ADDRESS:1120 S BEN MADDOX WY STE 100TELEPHONE:
(559) 802-1560
CITY:VISALIASTATE: CAZIP CODE:
93292
CAPACITY: 90CENSUS: 75DATE:
01/31/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
04:45 PM
MET WITH: Regional Director (RD) Dawn Reynoso; Non-Behavioral Program Director (PD) Gloria Waldrum; Behavioral Program Director (PD) Darian Jimenez;TIME COMPLETED:
08:15 PM
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An Annual visit was conducted on the date & time by Licensing Program Analyst (LPA) K. Mcclurg. LPA met with Regional Director (RD) Dawn Reynoso, Non-Behavioral Program Director (NB-PD) Gloria Waldrum, Behavioral Program Director (B-PD) Darian Jimenez.

Physical plant toured. Client classrooms, lunch areas, & kitchen toured. Facility has a separate room for ill clients. Internal & external passageways observed to be clear of obstruction. Sufficient number of client restrooms available. Bathrooms observed to be cleaned with no unpleasant odors. Hot water in resident restrooms. Date of last disaster drills conducted regularly. Fire extinguisher service date: 9/18/2023.

Records to be reviewed @ a later date.

Exit interview done with RM, NB-PD, & B-PD. Report provided.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kelly J. McClurg
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2024
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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