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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209233
Report Date: 01/16/2024
Date Signed: 01/16/2024 03:13:32 PM

Document Has Been Signed on 01/16/2024 03:13 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:LA CASA DELLA NONNAFACILITY NUMBER:
107209233
ADMINISTRATOR:RODRIGUEZ, LETICIAFACILITY TYPE:
740
ADDRESS:2570 W ALLUVIAL AVENUETELEPHONE:
(559) 400-6700
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY: 6CENSUS: 6DATE:
01/16/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
03:06 PM
MET WITH:Administrator, Leticia RodriguezTIME COMPLETED:
03:22 PM
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On 1/16/2024 Licensing Program Analyst (LPA) M. Garza arrived at facility to complete a Pre-Licensing visit. Upon arrival LPA met with Administrator, Leticia Rodriguez.

Per Administrator, they would like to reschedule the pre-licensing visit. Facility is currently having maintenance/housekeeping completed and is not currently ready for the inspection to be done.

Visit was rescheduled for Monday, January 22, 2024 at 1pm.

No deficiencies cited during visit. Exit interview completed with Administrator, Leticia. A copy of this report was provided.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2024
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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