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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209302
Report Date: 05/08/2023
Date Signed: 05/08/2023 06:06:58 PM

Document Has Been Signed on 05/08/2023 06:06 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:VELA SUITESFACILITY NUMBER:
107209302
ADMINISTRATOR:GRICE, SASHEILAFACILITY TYPE:
740
ADDRESS:6572 NORTH MARIPOSA ST.TELEPHONE:
(559) 438-0980
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY: 6CENSUS: 5DATE:
05/08/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
05:20 PM
MET WITH:Sasheila Grice Applicant/Licensee (L);TIME COMPLETED:
06:20 PM
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A continued Prelicensing visit was conducted on the date & times indicated above by Licensing Program Analyst (LPA) K. Mcclurg. LPA met with Sasheila Grice Applicant/Licensee (L).

Physical plant toured. Auditory alarms observed installed & operational on all exterior doors. Stove knobs, kitchen knives, & kitchen cleansers observed to be inaccessible to residents. Trash can with tight fitting lid in kitchen. Door from living to garage secured. Outside toured. Sufficient furnishings for residents with furniture in good repair. Side gate observed to be self-closing & self-latching. No hazards observed.

Pre-Licensing issues have been resolved. Pre-Licensing is now complete.
Exit interview conducted with L. Copy of report provided. CAB notified on completed Pre-Licensing prior to conclusion of visit.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kelly J. McClurg
LICENSING EVALUATOR SIGNATURE: DATE: 05/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2023
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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