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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107201840
Report Date: 02/19/2024
Date Signed: 02/19/2024 10:49:56 AM

Document Has Been Signed on 02/19/2024 10:49 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:MARIAN HOMES 3FACILITY NUMBER:
107201840
ADMINISTRATOR:JANARDHAN NAGARAJFACILITY TYPE:
740
ADDRESS:3238 JASMINE AVENUETELEPHONE:
(559) 347-9900
CITY:CLOVISSTATE: CAZIP CODE:
93611
CAPACITY: 6CENSUS: 5DATE:
02/19/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
08:48 AM
MET WITH:Susan KendakurTIME COMPLETED:
11:00 AM
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On 2/19/24, Licensing Program Analyst (LPA) M. Medina conducted an Annual Continuation Inspection. LPA met with Susan Kendakur, Licensee/Administrator to complete inspection.

LPA Medina reviewed both resident and staff files during inspection.

Licensee to submit the following documents to Fresno Regional Office no later than 2/29/24: LIC 308, LIC 309, LIC 500, and LIC 610E.

No deficiencies cited during inspection visit.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2024
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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