<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100407038
Report Date: 09/13/2019
Date Signed: 09/13/2019 09:45:53 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FIREBAUGH-LAS DELTAS UNIFIED SCHOOL DISTRICTFACILITY NUMBER:
100407038
ADMINISTRATOR:SANCHEZ, DELIA M.FACILITY TYPE:
850
ADDRESS:1691 "Q" STREETTELEPHONE:
(559) 659-3117
CITY:FIREBAUGHSTATE: CAZIP CODE:
93622
CAPACITY:144CENSUS: 76DATE:
09/13/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Delia Maria SanchezTIME COMPLETED:
10:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) Brannon and Ocegueda met with Early Childhood Coordinator, Maria Sanchez.

LPA Brannon conducted a prior visit on August 23, 2019. Licensee was required to make corrections to the facility. Today's visit was to ensure said corrections were completed. Licensee did make the noted corrections.

The two small restrooms are still under construction. Due to delays, the small restrooms estimated time of completion will be the first week in October. Another inspection visit will conducted to inspect the completed restrooms.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit. Exit interview conducted with Early Childhood Coordinator, Maria Sanchez. A copy of this report need to be placed in facility file for public review. A Notice of Site Visit was posted on parent board.

The following documents should be posted at the facility:
Ø PUB 269 – child passenger restraint systems poster
Ø PUB 393 – Notification of Parents Rights
Ø License
Ø Menus
Ø LIC 613A – Personal Rights form
Ø LIC 610 – Disaster Plan
Ø LIC 9148 – Earthquake Preparedness Checklist

A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1