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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107204178
Report Date: 06/23/2022
Date Signed: 06/23/2022 01:51:15 PM


Document Has Been Signed on 06/23/2022 01:51 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:QUALITY FAMILY SERVICES-GETTYSBURGFACILITY NUMBER:
107204178
ADMINISTRATOR:LAW, CORYFACILITY TYPE:
733
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:6CENSUS: 5DATE:
06/23/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Laura RomeroTIME COMPLETED:
12:15 PM
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On the above date, LPAs (Licensing Program Analysts) conducted a case management inspection at the QFS main office. Met with Human Resource Director Laura Romero.

The purpose of this inspection is to follow up on a technical violation issued on 06/13/22. The facility has replaced the lock on the window. Agency provided a photo of the correction on this date.
SUPERVISOR'S NAME: Juanita ArroyoTELEPHONE: (559) 650-7940
LICENSING EVALUATOR NAME: Briana PlacenciaTELEPHONE: 559-650-7878
LICENSING EVALUATOR SIGNATURE:
DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/23/2022
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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