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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107202659
Report Date: 10/26/2023
Date Signed: 10/26/2023 10:48:35 AM

Document Has Been Signed on 10/26/2023 10:48 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:LEONIE HOUSEFACILITY NUMBER:
107202659
ADMINISTRATOR:KENDAKUR, SUNDARIFACILITY TYPE:
740
ADDRESS:2931 CAESAR AVENUETELEPHONE:
(559) 347-9900
CITY:CLOVISSTATE: CAZIP CODE:
93612
CAPACITY: 6CENSUS: 5DATE:
10/26/2023
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Sundari KendakurTIME COMPLETED:
11:00 AM
NARRATIVE
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Licensing Program Analysts (LPA) M. Flores arrived at the facility unannounced to continue the completion of a required annual visit. LPA explained the purpose of this visit to staff and completed the annual of Licensee, Sundari Kendakur.

The residence was set at 72 F temperature. A sample of staff and resident files were reviewed.

An exit interview was conducted with the Licensee. No deficiencies were cited. A copy of this report was provided to AD.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Miriam Flores
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2023
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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