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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
547209333
Report Date:
10/29/2024
Date Signed:
10/29/2024 01:14:58 PM
Document Has Been Signed on
10/29/2024 01:14 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
FRESNO RO
,
1314 E SHAW AVE
FRESNO
,
CA
93710
FACILITY NAME:
SHERRILL MORRIS CARE HOMES
FACILITY NUMBER:
547209333
ADMINISTRATOR/
DIRECTOR:
MORRIS, TYLER
FACILITY TYPE:
735
ADDRESS:
514 BALMORAL DRIVE
TELEPHONE:
(559) 359-9214
CITY:
PORTERVILLE
STATE:
CA
ZIP CODE:
93257
CAPACITY:
4
CENSUS:
3
DATE:
10/29/2024
TYPE OF VISIT:
Case Management - Incident
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
01:01 PM
MET WITH:
Tyler Morris
TIME VISIT/
INSPECTION COMPLETED:
01:37 PM
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LPA, L. Xiong was at the above facility as a followup to an incident occurred at the above facility. LPA spoke to Administrator T. Morris about the incident during the visit.
SUPERVISORS NAME
:
Melinda Hoffmann
LICENSING EVALUATOR NAME
:
Les Xiong
LICENSING EVALUATOR SIGNATURE
:
DATE:
10/29/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/29/2024
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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