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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547209293
Report Date: 09/12/2024
Date Signed: 09/12/2024 08:04:25 PM

Document Has Been Signed on 09/12/2024 08:04 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 DEEP CREEK COURTFACILITY NUMBER:
547209293
ADMINISTRATOR/
DIRECTOR:		ESCOBEDO, JONATHANFACILITY TYPE:
737
ADDRESS:17287 DEEP CREEK COURTTELEPHONE:
(559) 667-9975
CITY:VISALIASTATE: CAZIP CODE:
93292
CAPACITY: 4CENSUS: 3DATE:
09/12/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:00 PM
MET WITH:Administrator (Admin) Jonathan Escobido -by telephone; Assistant Administrator (AA) Regan LockettTIME VISIT/
INSPECTION COMPLETED:
08:00 PM
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A Case Management Health & Safety visit was conducted by Licensing Program Analyst (LPA) K. Mcclurg. LPA met with Assistant Administrator (AA) Regan Lockett. LPA greeted AA & discussed purpose of visit. LPA spoke with Administrator (Admin) Jonathan Escobido by telephone, who authorized LPA to conduct visit with AA & for them to sign for receipt of report.

Visit conducted in response to incident as occurred on 9/4/24 & reported to the Department on 9/5/24.

LPA conducted facility walk-through. Alarm on perimeter gate set to "on" & operational. Auditory alarms on all facility doors & windows, including reinstallation for the window alarm disconnected during 9/4/24
AA walked LPA around inside perimeter of home showing window & projected route of egress, including method for not setting off perimeter alarm.

Details since incident discussed. Safety protocol & procedures, frequency of rounds, & staffing reviewed. Also reviewed current & project plans as applies to training & to physical plant.

Exit interview conducted with AA. Report provided.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kelly J. McClurg
LICENSING EVALUATOR SIGNATURE: DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2024
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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