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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100407063
Report Date: 11/01/2019
Date Signed: 11/01/2019 11:32:45 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:YOUNG WORLD II INFANT & PRESCHOOL CENTERFACILITY NUMBER:
100407063
ADMINISTRATOR:JOSLYN DIXONFACILITY TYPE:
850
ADDRESS:2955 N. FOWLER AVENUETELEPHONE:
(559) 291-0342
CITY:CLOVISSTATE: CAZIP CODE:
93611
CAPACITY:48CENSUS: 29DATE:
11/01/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Director-Irma VillaTIME COMPLETED:
11:45 AM
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On this date, Licensing Program Analyst (LPA) Luisa Gavoutian conducted an unannounced case management inspection. LPA met with Director Irma Villa and took a census.

Director Irma has been Director at the facility for approximately two weeks and was previously Assistant Director for approximately five years. During today's inspection, LPA reviewed Director Irma's file and verified qualification for Director. LPA obtained copies of documents and discussed with Director the additional information and documents that are needed. LPA left a written list of additional information still needing completion. Licensee shall submit additional paperwork to Community Care Licensing (CCL) within 30 days.

No deficiencies were cited in the areas observed today.

LIC 9213 Notice of Site Visit to be posted on parent board for 30 days.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2019
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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