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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103808413
Report Date: 03/10/2020
Date Signed: 03/10/2020 11:11:19 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:APPLES OF GOLD EDUCATIONAL CENTERFACILITY NUMBER:
103808413
ADMINISTRATOR:DUGAN, JACKIEFACILITY TYPE:
850
ADDRESS:7272 W. SHAW AVENUETELEPHONE:
(559) 276-7272
CITY:FRESNOSTATE: CAZIP CODE:
93723
CAPACITY:168CENSUS: 67DATE:
03/10/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Jackie DuganTIME COMPLETED:
11:30 AM
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On this date, 3/10/2020, Licensing Program Analyst (LPA) Ruby Ocegueda and Licensing Program Manager (LPM) Michael Duarte conducted a Case Management inspection for the purposes of reviewing a shared Play Ground Waiver and discuss the facilities Plan of Operation.

Today, LPA requested that Director Dugan add more details to the shared playground waiver letter she submitted by mail to Community Care Licensing (CCL). LPA reviewed the details she should add to the waiver letter.

LPA also reviewed the facilities Plan of Operation and discussed the requirement for all facility staff to follow this Plan in handling all activities and/or situations that might arise at any given time.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency cited.
An exit interview conducted with Director Jackie Dugan.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2020
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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