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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203358
Report Date: 12/12/2022
Date Signed: 12/14/2022 08:30:35 AM

Document Has Been Signed on 12/14/2022 08:30 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:POSITIVE DIRECTIONS #9FACILITY NUMBER:
157203358
ADMINISTRATOR:HOBBS, ANNFACILITY TYPE:
740
ADDRESS:329 EL CAMINO DRIVETELEPHONE:
(661) 721-3525
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY: 4CENSUS: 4DATE:
12/12/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Alicia Ortiz, Licensed Psyche Tech / Admininstrator's Assistant
TIME COMPLETED:
02:15 PM
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On 12/12/2022, Licensing Program Analyst (LPA) arrived at the facility unannounced to conduct a case management visit to deliver Resident R1's file. LPA obtained R1's file for copying purposes on Thursday 12/08/22. No residents were home at the time of visit.

No deficiencies cited on today's visit.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2022
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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