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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547209029
Report Date: 01/15/2025
Date Signed: 01/31/2025 09:26:30 AM

Document Has Been Signed on 01/31/2025 09:26 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:TODD FAMILY HOMEFACILITY NUMBER:
547209029
ADMINISTRATOR/
DIRECTOR:		TODD, TAMERAFACILITY TYPE:
740
ADDRESS:22755 AVE 178TELEPHONE:
(559) 784-2267
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 4TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
01/15/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Rosa KibinTIME VISIT/
INSPECTION COMPLETED:
04:26 PM
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Today, Licensing Program Analyst L. Xiong arrived at the facility unannounced to conduct the Annual Inspection. LPA met with staff Rosa Kibin and inform her the purpose of the visit.

Staff brought records for review and provided the facility tour for LPA. Facility appeared clean with no obstruction or fire clearance issues. All common areas have adequate seating and lighting. Resident bedrooms toured, rooms observed to have all required accommodations. Kitchen toured, LPA observed a 2-day supply of perishable and a 7-day supply of non-perishable food available for residents.

Smoke detector and carbon monoxide detectors observed operational during inspection. Fire extinguisher present with a service date of 1/2025. Water temperature observed to measure at 105 degrees F.

No deficiencies were observed.
Melinda HoffmannTELEPHONE: (559) -34-3274
Les XiongTELEPHONE: 559-410-1772
DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/15/2025
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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