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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547208883
Report Date: 12/20/2022
Date Signed: 12/20/2022 02:38:03 PM

Document Has Been Signed on 12/20/2022 02:38 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:PEOPLE'S CARE AVENUE 344FACILITY NUMBER:
547208883
ADMINISTRATOR:SMITH, BILLIEJEANFACILITY TYPE:
738
ADDRESS:14453 AVENUE 344TELEPHONE:
(909) 287-3557
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 4CENSUS: 2DATE:
12/20/2022
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
01:36 PM
MET WITH:Registered Behavior Technician Lead, Andrew QuirozTIME COMPLETED:
02:53 PM
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On 12/20/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct a case management - health checks visit. LPA introduced self, stated the purpose of the visit, and was granted entry to the facility. Facility staff contacted Administrator, BillieJean Smith via telephone. LPA disclosed the purpose of the visit to Administrator. Administrator gave verbal permission for LPA to meet with Registered Behavior Technician Lead, Andrew Quiroz (RBT). Upon entry to the facility, LPA observed a visitor screening log/temperature check.

There are 2 residents present during today's visit. Resident 1 observed to be socializing with facility staff. Resident 2 observed to be watching videos on a tablet. Staff observed to be wearing facial coverings. Staff observed to be a least an arm's length away from Resident 2.

LPA conducted a facility tour with RBT. No fire clearance issues observed during today's inspection. Facility bathrooms checked. Hot water measured at 113.5 degrees F. in bathroom 1 and 117.3 degrees F. in bathroom 2.

No deficiencies issued during today's inspection.

Exit interview conducted. A copy of this report was discussed and provided to Registered Behavior Technician Lead, Andrew Quiroz, whose signature on this form confirms receipt of this document.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2022
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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